Clinical manifestations of gastrointestinal form of food allergy in children and approaches to its diagnosis

Yu.R. Chernysh, O.M. Okhotnikova

Abstract


Gastrointestinal food allergy is caused by the development of allergic inflammation in the mucosa of the gastrointestinal tract. The mechanisms of this inflammation are immunogflobulin E (IgE)-mediated (oral allergic syndrome, immediate gastrointestinal hypersensitivity), non-IgE-mediated (protein-induced enterocolitis syndrome, protein-induced enteropathy, protein-induced allergic proctocolitis) and mixed IgE- and non-IgE-mediated reactions (eosinophilic esophagitis, eosinophilic gastritis and eosinophilic gastroenteritis). Gastrointestinal manifestations of food allergy are also combined with symptoms of atopic diseases, more often with atopic dermatitis, urticaria and angioedema. Clinical manifestations of allergic lesions of the gastrointestinal tract are different and non-specific. Common signs of gastrointestinal allergy include: vomiting (occurs from a few minutes to 4–6 hours after eating); сolic (immediately or several hours after eating); constipation; diarrhea; refusal of food (from a specific product or complete refusal to eat); abdominal pain; flatulence, the presence of mucus and eosinophils in the stool; poor appetite; headache. Differential diagnosis of gastrointestinal food allergy should be carried out with diseases such as disease and abnormalities in the development of the digestive system, mental and metabolic disorders, intoxications, infectious diseases, pancreatic endocrine gland failure, celiac disease, cystic fibrosis, immunodeficiencies, disaccharidic insufficiency, side effects of medications, endocrine pathology, irritable bowel syndrome. Methods for diagnosing gastrointestinal allergy, which currently exist, are limited and imperfect. This requires further scientific researches aimed at timely detection of this pathology, prevention in genetically predisposed children, development of optimal diagnostic algorithms, prevention of the progression of clinical manifestations, the choice of individual diet therapy and adequate medication. The literature review presents modern views on the diagnosis of gastrointestinal food allergy in children. The article details clinical manifestations and diagnostic approaches to certain types of gastrointestinal allergy depending on the mechanism of their occurrence.

Keywords


review; gastrointestinal food allergy; diagnosis; clinical manifestations; children

References


Prescott S, Allen KJ. Food allergy: riding the second wave of allergy epidemic. Pediatr. AllergyImmunol. 2011;22(2):156-60. doi: 10.1111/j.1399-3038.2011.01145.x.

Boyce JA, Assa'ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(60):S1-S58. doi: 10.1016%2Fj.jaci.2010.10.007.

Morita H, Nomura I, Matsuda A, et al. Gastrointestinal Food Allergy in Infants. Allergology International. 2013;62(3):297-307. doi: 10.2332/allergolint.13-RA-0542.

Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013;6:21. doi: 10.1186/1939-4551-6-21.

Castellazzi AM, Valsecchi C, Caimmi S, et al. Probiotics and food allergy. Ital J Pediatr. 2013;39:47. doi: 10.1186%2F1824-7288-39-47.

Dahan S, Roth-Walter F, Arnaboldi P, et al. Epithelia: lymphocyte interactions in the gut. Immunol Rev. 2007;215:243-53. doi: 10.1111/j.1600-065X.2006.00484.x.

Round JL, Mazmanian SK. The gut microbiota shapes intestina limmune responses during health and disease. Nat Rev Immunol. 2009;9(5):313-23. doi: 10.1038%2Fnri2515.

Holt PG, Strickland DH. Soothing signals: transplacental transmission of resistance to asthma and allergy. J Exp Med. 2009;206:2861-4. doi: 10.1084%2Fjem.20092469.

Caffarelli C, Baldi F, Bendandi B, et al. EWGPAG. Cow’s milk protein allergy in children: a practical guide. Ital J Pediatr. 2010;36:5. doi: 10.1186/1824-7288-36-5.

EFSA. EFSA Scientific Colloquium Summary Report. QPS: qualified presumption of safety of microorganisms in food and feed vi aCarlo Magno 1A-43126 Parma, Italy: EFSA (Autorità Europea Sicurezza Alimentare); 2004. Available from: https://www.efsa.europa.eu/en/supporting/pub/109e

Iannitti T, Palmieri В. Therapeutical use of probiotic formulations in clinical practice. ClinNutr. 2010;29(6):701-25. doi: 10.1016/j.clnu.2010.05.004.

Niankovsky SL. Ivakhnenko OS. Role and place of probiotics in prevention and treatment of allergy in children. Ditjachii Lіkar. 2013;4(25):24-31. (In Ukrainian).

Ann AT, Susan V. Gut Microbiota and Allergic Disease. New Insights Soc. 2016 Mar; 13(Suppl 1):51-4. doi: 10.1513/AnnalsATS.201507-451MG.

Lezhenko GO, Pashkova OYe. Place of probiotics in therapy and prevention of secondary acetonimic syndrome development. Zdorov'ye. 2015;3(63):31-4. (In Ukrainian).

Savustyanenko AV. Mechanisms of action of probiotics based on Bacillus subtilis. Aktual'naya Infektologiya. 2016;2(11):35-44. (In Russian). doi.org/10.22141/2312-413x.2.11.2016.77529.




DOI: https://doi.org/10.22141/2224-0551.12.5.2017.109280

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