Clinical and demographic features of children with legume allergy in a tertiary allergy clinic

Study objective: Food allergy is a growing public health concern, and legumes represent an important group of allergens, particularly in regions where they are consumed early and frequently in childhood. Data on the clinical characteristics of legume allergy in children from Turkey remain limited. To evaluate the clinical features, co-sensitization patterns, and tolerance development in children with legume allergy in a tertiary pediatric allergy clinic. Patients and methods: This retrospective study included children who presented with suspected legume allergy (excluding peanut-only allergy) between 2021 and June 2023. Demographic data, type of allergic reaction, coexisting atopic diseases, laboratory findings, and outcomes of skin prick tests and oral provocation tests (OPT) were reviewed. Statistical analyses were performed using SPSS 24.0, with P < 0.05 considered significant. Results: Twenty-three children (median age: 3 years, 56.3% female) were included. Lentil was the most frequent allergen (82.6%), followed by green lentil (39.1%), chickpea and peanut (34.8% each), bean (17.4%), and pea (4.3%). Urticaria was the most common manifestation (78.3%), and anaphylaxis occurred in 4 patients (17.4%), most often due to lentils. Multiple legume allergies were present in 52.2% of cases. Coexisting food allergy was observed in 47.8%, most commonly egg allergy. After a median 24-month follow-up, tolerance was achieved in 21.7% of patients who underwent OPT. Conclusion: Lentil is the most common cause of legume allergy among Turkish children, often presenting at an early age and occasionally leading to anaphylaxis. Multiple legume allergies and coexisting food allergy, particularly to egg, are frequent. Tolerance development occurs in about one fifth of cases. Larger prospective studies are needed to better define the natural history of legume allergy in this population.