Clinical Characteristics of Children Diagnosed with Food Allergy at Ankara University

İntroduction: To evaluate the clinical, laboratory, and follow-up characteristics of pediatric patients diagnosed with food allergy (FA) in a tertiary pediatric immunology and allergy clinic. Methods: This retrospective study included 300 children diagnosed with FA between January 2018 and January 2022. Patients were classified into IgE-mediated, mixed-type, and non-IgE-mediated FA. Demographic features, clinical symptoms, diagnostic tests (skin prick test-SPT, specific IgE), nutritional patterns, and tolerance outcomes were analyzed. Results: IgE-mediated FA was observed in 43.7%, mixed-type in 30.6%, and non-IgE-mediated in 25.7%. Cow’s milk (67.3%) and egg white (50.6%) were the most frequent allergens. Anaphylaxis occurred in 6.3% of patients. Complementary feeding patterns varied across groups; dairy products were more common in the IgE-mediated group (40.6%), while vegetables were more frequently introduced in the non-IgE (65.7%) and mixed (37.5%) groups. Tolerance was most often achieved for cow’s milk (80.1%), egg white (80.0%), and egg yolk (78.4%), with a median age of 3 years. In contrast, tolerance did not develop in 77% for walnut, 76.9% for hazelnut, and 71.4% for peanut. Primary immunodeficiency (PID) was identified in 21% of patients, predominantly transient hypogammaglobulinemia of infancy (79.0%). Multiple food allergies were significantly more frequent in patients with PID (42.8% vs. 35.8%, p=0.004). Conclusion: FA subtypes display distinct clinical and nutritional features. Routine immunologic evaluation may aid in the early identification of underlying PIDs in children with FA.