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Comment & Response
January 7, 2019

Risk of Appendicitis in IgE-Mediated Allergy

Author Affiliations
  • 1Department of Clinical Science and Education, Stockholm South General Hospital, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
  • 2Department of Surgery, Stockholm South General Hospital, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
JAMA Pediatr. Published online January 7, 2019. doi:10.1001/jamapediatrics.2018.4850

To the Editor We read with interest the recent work by Salö et al,1 reporting a low odds ratio of complicated appendicitis (adjusted odds ratio, 0.33; 95% CI, 0.18-0.59) in a subgroup of patients with documented IgE-mediated allergy. However, the conclusion of lower risk of complicated appendicitis in allergic children is not necessarily valid. The prevalence of allergy in the population at risk of appendicitis in the study was not presented, and therefore, the absolute risk of complicated appendicitis could be the same as in the nonallergic group, provided that the allergic children had an increased risk of uncomplicated appendicitis. If the proportion of allergic to nonallergic children with appendicitis is as reported in the study, the absolute risk of complicated appendicitis would be equal in allergic and nonallergic children, given a prevalence of allergy of 7%. With a prevalence of allergy lower than 7%, the absolute risk of complicated appendicitis in allergic children would be higher than in nonallergic children.

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