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Total Serum Immunoglobulin E is Higher in African than European American Children with Food Allergy
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  • Amal Assa'ad,
  • Lili Ding,
  • Qing Duan,
  • Tesfaye Mersha,
  • Christopher Warren,
  • Lucy Bilaver,
  • Megan Ulrich,
  • Mark Wlodarski,
  • Jialing Jiang,
  • Johnathan J. Choi,
  • Susan S. Xie,
  • Ashwin Kulkarni,
  • Susan Fox,
  • Sai Nimmagadda,
  • Mary Tobin,
  • Mahboobeh Mahdavinia,
  • Hemant Sharma,
  • Ruchi Gupta
Amal Assa'ad
Cincinnati Children's Hospital Medical Center Division of Allergy and Immunology

Corresponding Author:amal.assaad@cchmc.org

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Lili Ding
Cincinnati Children's Hospital Medical Center
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Qing Duan
Cincinnati Children's Hospital Medical Center
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Tesfaye Mersha
Cincinnati Children's Hospital Medical Center
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Christopher Warren
Northwestern University Feinberg School of Medicine
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Lucy Bilaver
Northwestern University Feinberg School of Medicine
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Megan Ulrich
Cincinnati Children's Hospital Medical Center Division of Allergy and Immunology
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Mark Wlodarski
Northwestern University Feinberg School of Medicine
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Jialing Jiang
Northwestern University Feinberg School of Medicine
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Johnathan J. Choi
Northwestern University Feinberg School of Medicine
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Susan S. Xie
Cincinnati Children's Hospital Medical Center Division of Allergy and Immunology
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Ashwin Kulkarni
Northwestern University Feinberg School of Medicine
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Susan Fox
Rush University Medical Center
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Sai Nimmagadda
Northwestern University Feinberg School of Medicine
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Mary Tobin
Rush University Medical Center
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Mahboobeh Mahdavinia
Rush University Medical Center
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Hemant Sharma
Children's National Hospital
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Ruchi Gupta
Cincinnati Children's Hospital Medical Center
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Abstract

Background: The effect of race, age, sex, atopy, environmental exposures, and social determinants of health on total serum immunoglobulin E (IgE) has not been examined in children with food allergy. Method: We conducted a cross-sectional analysis with univariable and multivariable linear mixed effect models of data from 398 African American and European American children 0-12 years with allergist-diagnosed food allergy from the multi-center, observational cohort FORWARD; total serum IgE in kU/L was the primary outcome measure. Results: Total serum IgE positively associated with African American race ( p < .0001), older age ( p < .0001), male sex ( p =. 0142), lower household income ( p = .0051), lower parent/caregiver education ( p = .0051), allergic rhinitis ( p < .0001), asthma ( p < .0001), eczema ( p = .0240), and a higher number of food allergies ( p < .0001), but not tobacco smoke exposure. After covariate adjustment in multivariable analysis, total serum IgE remained higher in African American than European American ( p < .0001), older than younger ( p < .0001), and male than female children and in children with allergic rhinitis ( p = .0083), asthma ( p < .0001), eczema ( p = .0140), and a higher number of food allergies ( p < .0001). Conclusions: We provide foundational data that total serum IgE varies by race in children with food allergy; values were higher in African American than European American children, independent of atopic status. These findings call attention to the need to establish race-dependent values of total serum IgE for diagnostic and therapeutic purposes.