有食物蛋白诱发过敏性直肠结肠炎病史的儿童发生 IgE 介导的食物过敏:五个病例的系列研究

IF 3.3 Q2 ALLERGY Frontiers in allergy Pub Date : 2024-03-28 DOI:10.3389/falgy.2024.1354106
Kim L. Tran, Elizabeth L. Wisner, G. Jeha, Luke A. Wall
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引用次数: 0

摘要

食物蛋白诱发的过敏性直肠结肠炎(FPIAP)是一种非 IgE 介导的过敏性疾病,表现为其他方面健康的婴儿出现血便。最常见的诱因是母乳或配方奶中的牛奶蛋白。一般认为 FPIAP 的预后良好,大多数婴儿在调整饮食后症状会得到缓解。大多数婴儿在 1-3 岁时就能耐受违规食物。在我院的 8 年中,发现并注意到有 5 名患者在婴儿期对牛奶产生 FPIAP,随后对牛奶和其他食物产生 IgE 介导的过敏反应。所有五例患者都出现了其他特应性疾病(四例为特应性皮炎)。至少有两名患者(目前分别为 8 岁和 16 岁)的 IgE 介导的牛奶过敏症状持续到学龄前期以后。其中三名患者对牛奶的 IgE 媒介反应非常严重,出现了过敏性休克或血管性水肿。此外,三名患者对牛奶以外的过敏原也出现了过敏性休克或血管性水肿。虽然 FPIAP 是一种非 IgE 介导的过程,传统上认为不会发展到婴儿出生后的第一年,但一些患有 FPIAP 的婴儿会发展为严重、持续的 IgE 介导的牛奶过敏。据我们所知,这是首次对此类患者进行详细的临床描述。
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Development of IgE-mediated food allergies in children with history of food protein-induced allergic proctocolitis: a series of five cases
Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated allergic condition that presents with hematochezia in otherwise healthy infants. It is most commonly induced by cow's milk protein via breast milk or formula. The prognosis for FPIAP is generally considered favorable with most infants achieving symptomatic resolution after diet modification. Most infants go on to tolerate the offending foods by 1–3 years of age. Over 8 years at our institution, five patients were identified and noted to have FPIAP to cow's milk during infancy with subsequent development of IgE-mediated allergic reaction to cow's milk and other foods. All five cases developed other atopic disorders (atopic dermatitis in four cases). IgE-mediated cow's milk allergy has persisted beyond the preschool years in at least two patients (currently 8 and 16 years old). For three of the patients, the IgE-mediated reaction to cow's milk was severe with development of anaphylaxis or angioedema. In addition, three patients experienced anaphylaxis or angioedema to allergens other than milk. While FPIAP is a non-IgE-mediated process traditionally thought not to progress past the first year of life, some infants with FPIAP develop severe, persistent IgE-mediated cow's milk allergy. To our knowledge, this is the first detailed clinical description of such patients.
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来源期刊
CiteScore
2.80
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审稿时长
12 weeks
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