牛奶过敏诊断和管理的地区差异。

IF 3.2 Q1 PEDIATRICS Clinical and Experimental Pediatrics Pub Date : 2024-11-01 Epub Date: 2024-10-28 DOI:10.3345/cep.2023.01550
Fabian Hendricx, Emma Robert, Jaime A Ramirez-Mayans, Karen Rubi Ignorosa Arellano, Erick M Toro Monjaraz, Yvan Vandenplas
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引用次数: 0

摘要

背景: :目的: :本研究旨在比较墨西哥、中东和欧洲儿科胃肠病学、肝病学和营养学会(ESPGHAN)专家对 CMA 相关声明的投票结果:方法:3 个专家组就相同的 10 项陈述进行投票。每位参与者采用 0-9 分制进行匿名投票(≥6 分表示同意;结果:......):3 个专家组达成了广泛共识。大家一致认为,婴儿肠绞痛作为一种单一表现并不能提示 CMA。所有小组都确认,在轻度/中度 CMA 病例中,广泛水解配方奶是首选的消除饮食;不过,水解大米配方奶也是一种替代选择。以氨基酸为基础的配方奶应保留给有严重症状的婴儿。关于大豆配方奶粉的投票结果的差异凸显了意见分歧。13 位西班牙国家卫生与健康委员会专家中有 2 位(15%)、14 位中东专家中有 1 位(7%)、26 位墨西哥专家中有 6 位(23%)不同意以下说法:大豆配方奶粉不应作为诊断性消除饮食的首选,但在某些情况下出于经济、文化和适宜性等原因可以考虑。所有 ESPGHAN 和墨西哥专家都认为,益生菌、益生元或合成益生菌对消除性饮食对 CMA 的疗效没有附加价值,而 14 位中东专家中有 3 位(21%)认为有足够的证据:尽管三组专家接受了所有声明,但由于地域、文化、成本和配方奶粉的供应情况不同,三组专家的观点也存在相关差异。这些发现强调了制定地区性指南的必要性。
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Regional differences in diagnosis and management of cow's milk allergy.

Background: Various guidelines for the diagnosis and management of cow's milk allergy (CMA) have been published.

Purpose: This study aimed to compare voting outcomes of experts from Mexico, the Middle East, and the European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) on statements regarding CMA.

Methods: The 3 expert groups voted on the same 10 statements. Each participant voted anonymously using a score of 0-9 (≥6 meant agreement; <5 reflected disagreement). If <75% of the participants agreed with the statement, it was rejected. None of the groups was aware of the voting outcomes of another group.

Results: There was broad consensus amongst the 3 groups. Agreement was reached that infant colic as a single manifestation is not suggestive of CMA. All groups confirmed that an extensively hydrolysed formula is the preferred elimination diet in mild/moderate CMA cases; however, hydrolysed rice formula is an alternative. Amino acid-based formulas should be reserved for infants with severe symptoms. The discrepancy in voting outcomes regarding soy formulas highlights the differences in opinions. Two of 13 ESPGHAN experts (15%), 1 of 14 Middle East experts (7%), and 6 of 26 Mexican experts (23%) disagreed with the statement that soy formula should not be the first choice for the diagnostic elimination diet but can be considered in some cases for economic, cultural, and palatability reasons. All of the ESPGHAN and Mexican experts agreed that there was no added value of probiotics, prebiotics, or synbiotics to the efficacy of elimination diets on CMA, whereas 3 of 14 Middle East experts (21%) determined that there was sufficient evidence.

Conclusion: Although all statements were accepted by the 3 groups, there were relevant differences illustrating variations according to geography, culture, cost, and formula availability. These findings emphasize the need for region-specific guidelines.

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来源期刊
CiteScore
8.00
自引率
2.40%
发文量
88
审稿时长
60 weeks
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