Food allergen sensitization on a standardized specific-IgE core panel in the West Bank, Palestine: a retrospective analysis of 1,339 Patients, 2016–2026

Abstract Local data on food allergen sensitization in the West Bank of Palestine are scarce, and clinicians rely on allergen panels derived from dissimilar Western populations. We describe the sensitization profile of patients referred for specific-IgE (sIgE) testing, using a deduplicated cohort and a fixed core panel to enable valid patient-level and temporal inference. We analysed routinely collected food sIgE records from a multi-branch private laboratory network (archive 2004–2026). Specific IgE was measured with the EUROLINE semi-quantitative line immunoblot assay (EUROIMMUN, Lübeck, Germany). Records were deduplicated to unique individuals using a patient identifier. The primary cohort comprised patients tested on the standardized panel introduced in 2016. Because the panel’s composition changed once during the study, all primary analyses were based on a stable core of 19 food allergens assayed in ≥ 99% of patients, giving a common denominator across patients and calendar time. Sensitization was defined as sIgE ≥ 0.35 kU/L. Associations were assessed by multivariable logistic regression adjusting for age, sex, calendar period and governorate. Of 1,675 records, 1,633 represented unique patients; 1,339 tested on the standardized panel (2016–2026) formed the primary cohort (median age 23 years; 43.5% aged < 18). On the core panel, 26.7% (95% CI 24.4–29.1) were sensitized to ≥ 1 food and 18.7% were polysensitized. The leading sensitizers were cow milk (11.5%), sesame (10.0%), peanut (8.8%), egg white (8.7%) and rice (8.1%). Sensitization peaked in early childhood (40.9% at 1–5 years; adjusted OR 2.60, 95% CI 1.89–3.59) and was higher in males (34.3% vs. 19.9%; aOR 1.83, 1.42–2.37). The infant subgroup (< 1 year, n = 40) was underpowered (aOR 1.94, 0.95–3.93). Core-allergen sensitization was stable across calendar periods (27.4%, 25.1%, 27.5%; trend p = 0.48); an apparent decline seen when non-core allergens were included was an artefact of a mid-study panel change. Governorate was not independently associated with sensitization. Among West Bank patients tested on a standardized panel, food sensitization was common and polysensitization frequent, with a distinctly Levantine hierarchy led by cow milk and sesame. The early-childhood peak (1–5 years) and male excess were robust to adjustment, while apparent temporal and geographic differences reflected changes in testing rather than disease. Findings describe sensitization in referred patients, not clinical food allergy.