Swedish researchers have established a link between allergies and complications of appendicitis.
As at least every third child with appendicitis develops complicated disease with gangrene or perforation, and there is a need to identify new risk factors, said the authors. They investigated a hypothesis suggesting children with IgE-mediated allergy have a lower risk of complicated appendicitis by evaluating a cohort of consecutive children who underwent appendicitis surgery for association between allergy and appendicitis severity.
The retrospective cohort study, published in JAMA Pediatrics, involved 605 children and adolescents aged under 15, who underwent appendectomy for acute appendicitis at a tertiary paediatric surgery center in Sweden between 01 January 2007 through 31 July 2017.
Of these,102 had IgE-mediated allergy and 503 had no allergy. Complicated appendicitis occurred in 20 children with IgE-mediated allergy (19.6%) compared with 236 with no allergy (46.9%).
According to the authors, the findings identify a "strong and previously unknown" association between allergy and appendicitis, and suggest allergic immune responses modulate the severity of appendicitis. "These findings offer new opportunities to understand the pathogenesis and clinical prediction of adverse appendicitis outcome," they concluded, although they added the study results must be interpreted in the context of a non-randomised design.