ABSTRACT
Objetivo: Analisar a relação entre o desmame precoce e o desenvolvimento de alergias alimentares por meio de uma revisão integrativa. Método:Revisão integrativa da literatura realizada através das bases de dados Pubmed, Mesh e Scielo.Resultados:Através da busca pelos descritores determinados, foram selecionados 25 estudos científicos que atenderam aos critérios de inclusão. Devido sua grande composição, o leite humano é responsável pela promoção do crescimento das bactérias com efeito bifidogênico, estando em quantidades superiores nos lactentes em AME. Conclusão: Apesar de alguns dos estudos não mostrarem resultados significativos em relação ao leite materno ser um fator protetor contra as alergias alimentares, nenhum deles deixoude incentivar o AM ou mostrar os seus benefícios já cientificamente comprovados.
Objective: To analyze the relationship between early weaning and the development of food allergies through an integrative review. Method: Integrative literature review performed through the Pubmed, Mesh and Scielo databases. Results: Through the search for the descriptors determined, 25 scientific studies that met the inclusion criteria were selected. Due to its large composition, human milk is responsible for promoting the growth of bacteria with bifidogenic effect, being in higher amounts in infants in EBF. Conclusion: Although some of the studies did not show significant results regarding breast milk being a protective factor against food allergies, none of them failed to encourage BF or show its scientifically proven benefits.
Objetivo: Analizar la relación entre el destete precoz y el desarrollo de alergias alimentarias a través de una revisión integradora. Metodo:Revisión integradora de la literatura realizada a través de las bases de datos Pubmed, Mesh y Scielo. Resultados: A través de la búsqueda de los descriptores determinados, se seleccionaron 25 estudios científicos que cumplieron con los criterios de inclusión. Debido a su gran composición, la leche humana es responsable de promover el crecimiento de bacterias con efecto bifidogénico, estando en mayores cantidades en bebés en LME. Conclusión:Aunque algunos de los estudios no mostraron resultados significativos con respecto a que la leche materna sea un factor protector contra las alergias alimentarias, ninguno de ellos falló en fomentar la BF o mostrar sus beneficios científicamente probados.
Subject(s)
Milk, Human , Weaning , Breast Feeding , Food HypersensitivityABSTRACT
El etiquetado de alérgenos alimentarios en los productos es hoy uno de los temas que genera grandes preocupaciones en la población. Objetivo: evaluar cómo las distintas empresas se adecuaron a la legislación vigente sobre alérgenos en Argentina. Materiales y Métodos: en 2019 se relevaron 16 productos alimenticios dulces y salados que se codificaron como: ME, MN, TO, PA, GD, F, MLV, QM, BB, BT, TR, TM, PFK, BQK, CHB y CM. Para realizar la comparación de las declaraciones de alérgenos, a mediados de 2022 se volvieron a relevar los 16 productos, encontrándose tres de ellos discontinuados. El análisis del rótulo comprendió la verificación del cumplimiento de la declaración de alérgenos, uso de frases de advertencia (FA) y presentación de la información. Resultados y Discusión: en el 2019 en la declaración de alérgenos se incluyen expresiones como: "contiene gluten", en un 50% de los productos analizados. Por otro lado, en 5 de los 15 productos con FA, hay expresiones del tipo "puede contener trazas ". Asimismo, se incluye en 5 productos, al sésamo, alérgeno contemplado por legislaciones diferentes a la Argentina. Con respecto a la presencia de dióxido de azufre y sulfitos, hay dos productos que los declaran a continuación de la lista de ingredientes y otros dos productos que declaran a los sulfitos en sus frases de advertencia. Al analizar los rótulos en el 2022, el 80% de los productos analizados no presentan inconsistencias en lo que respecta a la presentación de la información. Conclusiones: en el estudio comparativo se observa una mejora en la correcta declaración de alérgenos y frases de advertencia. Sin embargo, después de más de cinco años de haber finalizado el plazo otorgado a las industrias para la adecuación de los rótulos, para una adecuada declaración de alérgenos, persisten algunos productos no conformes
The labeling of food allergens in products is today one of the issues that generates great concern in the population. Objective: was to evaluate how different companies adapted to current legislation on allergens in Argentina. Materials and methods: in 2019, sixteen sweet and salty food products were surveyed, coded as: ME, MN, TO, PA, GD, F, MLV, QM, BB, BT, TR, TM, PFK, BQK, CHB and CM. To compare the allergen declarations, in mid-2022 the sixteen products were surveyed again, finding three discontinued products. The analysis of the label included verification of compliance with the allergen declaration, use of warning phrases (FA), and presentation of information. Results and Discution: in 2019, the declaration of allergens includes expressions such as: "contains gluten", in 50% of the products analyzed. On the other hand, in five of the fifteen products with FA, there are expressions such as "may contain traces...". Likewise, it is included in five products, sesame, an allergen contemplated by legislations other than Argentina. Regarding the presence of sulfur dioxide and sulphites, there are two products that declare them below the list of ingredients and two other products that declare sulphites in their warning phrases. When analyzing the labels in 2022, 80% of the analyzed products do not present inconsistencies with regard to the presentation of the information.Conclusions: in the comparative study, an improvement is observed in the correct declaration of allergens and warning phrases.However, more than five years after the end of the period granted to the industries for the adaptation of the labels for an adequate declaration of allergens, some errors persist in them
Subject(s)
Food Labeling , Food HypersensitivityABSTRACT
El síndrome de enterocolitis inducido por proteínas de los alimentos (FPIES, por su sigla en inglés) es una reacción alérgica no mediada por inmunoglobulina E (IgE) con síntomas gastrointestinales, como vómitos y diarrea. El diagnóstico se basa en criterios clínicos y en una prueba de provocación para confirmarlo. Es una enfermedad desconocida en las unidades neonatales, debido a la inespecificidad de los síntomas en los recién nacidos. La cifra de metahemoglobina elevada es una opción sencilla de aproximación diagnóstica. Se describe el caso clínico de un recién nacido que ingresa al servicio de urgencias por deshidratación, letargia, vómitos, diarrea y acidosis metabólica grave con elevación de metahemoglobina, con mejora clínica y recuperación total tras el inicio del aporte de fórmula elemental. La sospecha diagnóstica se confirmó tras la prueba de provocación positiva.
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated allergic reaction with gastrointestinal symptoms, such as vomiting and diarrhea. FPIES diagnosis is based on clinical criteria and on a food challenge test. It is an unknown disease in neonatal units due to its nonspecific symptoms in newborn infants. An elevated methemoglobin level is a simple way to approach diagnosis. Here we describe a clinical case of a newborn admitted to the emergency department because of dehydration, lethargy, vomiting, diarrhea, severe metabolic acidosis, and a high methemoglobin level. Clinical improvement and complete recovery was achieved after initiation of elemental formula. The diagnostic suspicion was confirmed after a positive challenge test.
Subject(s)
Humans , Infant, Newborn , Acidosis/diagnosis , Acidosis/etiology , Enterocolitis/diagnosis , Enterocolitis/etiology , Food Hypersensitivity/complications , Food Hypersensitivity/diagnosis , Syndrome , Vomiting/etiology , Methemoglobin , Dietary Proteins , Diarrhea/etiologyABSTRACT
BACKGROUND@#Recent studies indicate that the timing of introduction of potentially allergenic food is crucial for the development of food allergy in children. This cross-sectional study aimed to clarify the reality of allergen food intake in a general population of young children in Japan.@*METHODS@#A questionnaire survey of caregivers was conducted at health checkups for 1.5-year (18-month)-old and 3-year-old children in the fall of 2020. The caregivers were asked about (1) the presence/absence of allergic disease symptoms based on the ISAAC questionnaire, and (2) foods that caregivers avoided giving their children. Ordinal logistic regression analyses were periformed to determine factors associated with food avoidance.@*RESULTS@#Questionnaires were distributed to 1720 caregivers, and 1603 (93%) responded. The responders consisted of 771 and 832 caregivers who participated in 1.5-year-old and 3-year-old checkups, respectively. The prevalence of allergic diseases was comparable to recent epidemiological studies in Japan, indicating that the population may be representative. At 1.5 years old, more than 50% of the children were not exposed to peanuts, tree nuts, fish eggs, shellfish, and buckwheat. At 3 years old, the avoidance rates of the foods had decreased but were still between 18.8% and 32.0%. On the other hand, the avoidance rates of chicken egg and cow's milk, the top 2 common allergenic foods in Japan, were much lower at 2.8% and 1.5% at 1.5 years, and they decreased to 1.4% and 0.7% at 3 years old, respectively. Ordinal logistic analysis showed that avoidance of chicken egg, cow's milk, and wheat was associated with food allergy diagnosis and chicken egg avoidance with eczema, but avoidance of other foods showed no associations with any risk factors for food allergy.@*CONCLUSION@#Caregivers avoided giving various foods, independent of allergy risk factors, to their young children. Since delayed introduction of an allergenic food has been reported to increase the risk of developing an allergy to the food, the results warrant future investigation of the development of food allergies in relation to current eating habits and recommendations.
Subject(s)
Female , Animals , Cattle , Humans , Cross-Sectional Studies , Japan/epidemiology , Food Hypersensitivity/complications , Risk Factors , Food , AllergensABSTRACT
Objective: To investigate the clinical characteristics of children with allergic diseases suffering from SARS-CoV-2 Omicron variant strains. Methods: This was a cross-sectional study. A total of 43 pediatric patients with allergic diseases infected by SARS-CoV-2 from April 25, 2022 to June 8, 2022 in Shanghai Jiao Tong University School of Medicine were selected as the allergic disease group, while 114 cases without underlying diseases and 16 cases with other underlying diseases were selected as control groups diagnosed at the same period. Clinical data including clinical features, laboratory tests, duration of hospitalization, and the time to negative turn of novel coronavirus nucleic acid were collected and analysed. Kruskal-Wallis H test, chi-square test or Fisher exact test were used for comparison among three groups. Results: Among the 43 patients with allergic diseases, 28 were males and 15 were females, with an age of 4.4 (2.1, 8.2) years on admission, including 32 mild cases and 11 common cases. The allergic disease group included 20 cases (46.5%) of atopic dermatitis and eczema, followed by 14 cases (32.6%) of rhinitis, 8 cases (18.6%) of food allergies, 7 cases (16.3%) of asthma, 4 cases (9.3%) of allergic conjunctivitis and 2 cases (4.7%) of drug allergy. Among the 114 cases without underlying diseases, 57 were males and 57 were females, with an age of 2.8 (1.2, 5.6) years on admission, including 93 mild cases and 21 common cases. Among the 16 cases with other underlying diseases, 9 were males and 7 were females, with an age of 3.0 (2.6, 10.8) years on admission, including 13 cases mild and 3 cases common cases. Children with allergic diseases had higher frequency of sore throat and vomiting than those without underlying diseases (10 cases (23.3%) vs.9 cases (7.9%), 14 cases (32.6%) vs. 11 cases (9.6%), χ²=6.93, 12.24, both P<0.05). The lymphocyte count of patients with allergic disease was lower than those without underlying disease (1.1 (0.7,1.7)×109 vs. 1.6 (1.1,2.7)×109/L, H=-28.00,P=0.005). There were no significant differences in age, gender, typing of SARS-CoV-2, the duration of hospitalization, cycle threshold values of SARS-CoV-2 and the time to negative turn of novel coronavirus nucleic acid among the three groups (all P>0.05). Conclusions: Children with allergic diseases may suffer from sore throat and vomiting more frequently when infected with SARS-CoV-2 Omicron variant. The combination of allergic diseases hardly influenced the disease course of SARS-CoV-2 in children.
Subject(s)
Male , Female , Humans , Child , SARS-CoV-2 , Cross-Sectional Studies , COVID-19 , China/epidemiology , Food Hypersensitivity , PharyngitisABSTRACT
Oral allergy syndrome (OAS) is an IgE-mediated hypersensitivity. Patients with pollen allergy will experience oropharyngeal allergy after eating fresh fruits or vegetables containing homologous pathogenesis-related allergen, occasionally accompanied by systemic symptoms, it is a special type of food hypersensitivity in which respiratory allergens and food allergens are similar structurally and lead to the cross-reactivity. At present, there is little research and attention to it in China. To master the definition, epidemiological characteristics, pathological mechanism, diagnosis, prevention and treatment of OAS is very important to the prevention and control of OAS. This article reviews the research progress of OAS, providing reference and prevention basis for clinicians to improve the diagnosis and differential diagnosis of OAS.
Subject(s)
Humans , Pollen , Food Hypersensitivity/diagnosis , Rhinitis, Allergic, Seasonal/therapy , Allergens , Fruit , Cross ReactionsABSTRACT
There are many types in food allergy, and the most common is mediated by IgE. Currently, the diagnosis of food allergy mainly relied on skin prick test and serum specific IgE of allergen extract, which can not identify cross-sensitization. Component-resolved diagnosis (CRD) can identify the major allergen components and cross-components of food allergens, which plays an important role in dietary guidance, prognosis monitoring and diagnosis of special types of IgE-mediated food allergy. This article enumerates clinical characteristics of the IgE-mediated common food allergies, such as milk, egg and seafood allergy, and special type of food allergy, such as cat pork syndrome, oral allergy syndrome, α-gal syndrome and food-dependent exercise-induced anaphylaxis, summarizes the advances of CRD in these types of IgE-mediated food allergy, in order to provide an evidence for the diagnosis, treatment and prevention of IgE-mediated food allergy.
Subject(s)
Humans , Allergens , Immunoglobulin E , Food Hypersensitivity/diagnosis , Skin TestsABSTRACT
Objective To investigate the preventive therapeutic effect and possible mechanism of single chain variable fragments chimeric protein (SD) of ovalbumin epitopes internalizing receptor DEC-205 antibody on food allergy in mice. Methods Mice were randomly divided to five groups (control, PBS, scFv DEC 100 μg, SD 50 μg, SD 100 μg) and treated for 24 hours before OVA administration. After challenge, the serum level of OVA-specific IgE, IgG1, IgG2a and IL-4 were detected by ELISA. Infiltration of eosinophils and mast cells in the jejunum was observed by HE staining and toluidine blue staining respectively. The bone marrow of tibia and femur was isolated and cultured to obtain immature dendritic cells(BMDCs), which were further treated with LPS (10 ng/mL), TSLP (50 ng/mL), scFv DEC protein (1000 ng/mL) and SD protein (10,100,1000)ng/mL for 24 hours, and the IL-10 level of supernatant was assayed by ELISA. Results Compared with PBS group, the number of SD-treated mice with diarrhea was markedly reduced. The difference in rectal temperature and the levels of serum OVA-specific IgE, IgG1, IgG2a and IL-4 decreased significantly after prophylactic administration of SD; The number of eosinophils and mast cells in jejunum also decreased significantly while the IL-10 level in the supernatant of BMDCs increased significantly after SD intervention. Conclusion SD mitigates experimental FA response by fosters the immune tolerance property of dendritic cells.
Subject(s)
Mice , Animals , Ovalbumin , Interleukin-10 , Single-Chain Antibodies/genetics , Immunoglobulin E , Epitopes/therapeutic use , Interleukin-4 , Food Hypersensitivity/prevention & control , Immunoglobulin G , Recombinant Fusion Proteins/genetics , Mice, Inbred BALB C , Disease Models, AnimalABSTRACT
Food-dependent, exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening disorder that often occurs with exercise, and patients typically have eaten a specific food within hours before disease onset. This disease is exceedingly rare, with a prevalence of 0.02%. No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly. Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years. As the anaphylactic symptoms had not been controlled after traditional treatments, the patient was given subcutaneous injection of dupilumab seven times within 33 weeks. During dupilumab treatments, the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis. Thus, Dupilumab may improve the allergic reactions in FDEIA patients.
Subject(s)
Male , Humans , Child , Anaphylaxis/etiology , Food Hypersensitivity/diagnosis , Exercise-Induced Allergies , Antibodies, Monoclonal, Humanized/therapeutic useABSTRACT
El parto prematuro, la cesárea, el uso de antibióticos y la lactancia materna limitada son señalados como responsables en parte del aumento de enfermedades crónicas no transmisibles en niños, como las alergias, principalmente la alergia a la proteína de la leche de vaca (APLV). Quienes desarrollan enfermedades alérgicas muestran diferencias en la composición de su microbiota intestinal durante los primeros meses de vida, en comparación con los que no lo hacen. Las intervenciones tempranas para modular la microbiota intestinal y el sistema inmunológico pueden ser herramientas claves para el abordaje y tratamiento de la APLV. El criterio clínico y el trabajo interdisciplinario de alergólogos, gastroenterólogos, inmunólogos, microbiólogos y nutricionistas le permitirá al pediatra lograr un adecuado diagnóstico y un tratamiento oportuno. En este contexto, el empleo de bióticos (prebióticos, probióticos, sinbióticos y posbióticos) como herramientas nutricionales complementarias tiene un presente con sustento científico y un futuro promisorio para la prevención y tratamiento de estas patologías.
Preterm birth, C-section, antibiotic use, and limited breastfeeding are blamed in part for the increasing incidence of chronic noncommunicable diseases among children, such as allergies, mainly cow's milk protein allergy (CMPA). Those who develop allergic diseases, against those who do not, show differences in the composition of their gut microbiota during the first months of life. Early interventions to modulate the intestinal microbiota and the immune system may be the key tools for the management of CMPA. Clinical judgment and the interdisciplinary work of allergists, gastroenterologists, immunologists, microbiologists, and nutritionists will allow pediatricians to achieve an adequate diagnosis and a timely treatment. In this setting, the use of biotics (prebiotics, probiotics, synbiotics, and postbiotics) as supplementary dietary tools is scientifically supported at present and seems to be very promising for the prevention and treatment of these conditions.
Subject(s)
Humans , Animals , Infant, Newborn , Milk Hypersensitivity , Probiotics/therapeutic use , Premature Birth , Food Hypersensitivity/diagnosis , Food Hypersensitivity/therapy , Cattle , ImmunomodulationABSTRACT
A urticária aguda é uma causa frequente de consulta com alergistas, caracterizada por urticas e/ou angioedema. Embora autolimitada e benigna, pode causar desconforto significativo e raramente representar uma doença sistêmica grave ou reação alérgica com risco de vida. Nesta revisão, elaborada pelo Departamento Científico de Urticária da Associação Brasileira de Alergia e Imunologia, foram abordadas as principais questões referentes ao tema para auxiliar o médico especialista e generalista.
Acute urticaria is a frequent cause of consultations with allergists, being characterized by wheals and/or angioedema. Although self-limited and benign, it may cause significant discomfort and uncommonly represent a serious systemic disease or life-threatening allergic reaction. In this review prepared by the Urticaria Scientific Department of the Brazilian Association of Allergy and Immunology, the main questions about this topic are addressed to help specialists and general practitioners.
Subject(s)
Humans , Urticaria , Epinephrine , Milk Hypersensitivity , Egg Hypersensitivity , Drug Hypersensitivity , Shellfish Hypersensitivity , Nut and Peanut Hypersensitivity , Histamine H1 Antagonists , Anaphylaxis , Spider Bites , Physicians , Societies, Medical , Therapeutics , Anti-Inflammatory Agents, Non-Steroidal , Sweet Syndrome , Dermatitis, Allergic Contact , Adrenal Cortex Hormones , Hypereosinophilic Syndrome , Schnitzler Syndrome , Mastocytosis, Cutaneous , Diagnosis , Allergy and Immunology , Erythema , Angioedemas, Hereditary , Food Hypersensitivity , Allergists , Hypersensitivity , AngioedemaABSTRACT
Nas últimas décadas observa-se aumento na prevalência mundial de alergia alimentar, que já acomete aproximadamente 6% das crianças, atribuído à interação entre fatores genéticos, ambientais e alterações na resposta imunológica e pode envolver reações mediadas por IgE, não mediadas e mistas. As formas não IgE mediadas decorrem de reação de hipersensibilidade tardia, mediada por linfócitos T e afetam prioritariamente o trato gastrointestinal, como a Síndrome da enterocolite induzida por proteína alimentar (FPIES), Síndrome da proctocolite alérgica induzida por proteína alimentar (FPIAP), Síndrome da enteropatia induzida por proteína alimentar (FPE) e doença celíaca. As características destas reações podem ser diferenciadas por sua apresentação clínica, gravidade, idade de início e história natural. Entre as reações alérgicas aos alimentos não IgE mediadas, a proctocolite alérgica é a mais frequente. Geralmente ocorre no primeiro ano de vida e apresenta excelente prognóstico. Embora costume ter um curso benigno, traz grande preocupação aos cuidadores por frequentemente cursar com quadro de hematoquezia exigindo diagnóstico diferencial adequado. O conhecimento e manejo da proctocolite alérgica é de suma importância para a prática médica em Alergia e Imunologia. Seu diagnóstico é baseado na história clínica seguindo-se dieta de exclusão, especialmente do leite de vaca, com subsequente provocação oral, que geralmente pode ser realizada no domicílio. O diagnóstico preciso é importante, para se evitar dietas de exclusão desnecessárias. Nesta revisão foram utilizados artigos publicados nos últimos anos, com busca realizada através da base PubMed envolvendo revisões, diagnóstico e tratamento de alergias não IgE mediadas, com foco em proctocolite alérgica.
An increase in the worldwide prevalence of food allergies has been observed in the past decades, currently affecting 6% of children. This increase has been associated with the interaction between genetic, environmental, and immune response factors and can be observed in IgE, non-IgE, and mixed mediated reactions. Non-IgE mediated food allergies result from delayed-type hypersensitivity and mostly affect the gastrointestinal tract, such as food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), food protein-induced enteropathy (FPE), and celiac disease. These reactions can be differentiated by their clinical presentation, severity, age at onset, and natural history. Among non-IgE-mediated allergic reactions to food, allergic proctocolitis is the most frequent. It usually develops in the first year of life and has excellent prognosis. Although it has a benign course, allergic proctocolitis is challenging for health care professionals because it often presents with hematochezia, requiring an accurate differential diagnosis. Knowledge and management of allergic proctocolitis is of paramount importance for medical practice in allergy and immunology. Its diagnosis is based on clinical history followed by elimination diet, especially cow's milk, with subsequent oral food challenge, which may usually be performed at home. Accurate diagnosis is important to avoid unnecessary elimination diets. For this review, PubMed database was searched for recently published literature reviews and studies on the diagnosis and treatment of non- IgE mediated allergies, with a focus on allergic proctocolitis.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Proctocolitis , Food Hypersensitivity , Therapeutics , Immunoglobulin E , T-Lymphocytes , Celiac Disease , Prevalence , Milk Hypersensitivity , PubMed , Gastrointestinal Tract , Diagnosis, Differential , Allergy and Immunology , Gastrointestinal HemorrhageABSTRACT
INTRODUCCIÓN: La colitis eosinofílica y la colitis de la enfermedad inflamatoria intestinal, son dos entidades que pueden compartir similares características clínicas, endoscópicas y terapéuticas pero diferentes criterios diagnósticos. OBJETIVOS: Describir el caso clínico de un niño preescolar con antecedente de alergia alimentaria, de hospitalizaciones y uso de antibióticos por varias ocasiones, que evoluciona con diarrea crónica intermitente. CASO CLÍNICO: Se trata de un paciente masculino, de 3 años 5 meses, con antecedente de alergia alimentaria con cuadro crónico de dolor abdominal, diarrea y retraso en el crecimiento. Se realiza abordaje de diarrea crónica. RESULTADOS: Con hallazgos clínicos de enfermedad inflamatoria intestinal y descripción histopatológica de colitis eosinofílica, se considera la asociación entre estas dos patologías sin dejar la posibilidad de que esta última se trate de una fase inicial de enfermedad inflamatoria intestinal. CONCLUSIONES: El tratamiento de pacientes con colitis eosinofílica complicada es similar a la enfermedad inflamatoria intestinal, se requiere seguimiento clínico, endoscópico e histopatológico de pacientes con colitis eosinofílica a largo plazo.
INTRODUCTION: Eosinophilic colitis and inflammatory bowel disease colitis are two entities that may share similar clinical, endoscopic and therapeutic features but different diagnostic criteria. OBJECTIVES: To describe the clinical case of a preschool child with a history of food allergy, hospitalizations and use of antibiotics for several occasions, who evolves with chronic intermittent diarrhea. CLINICAL CASE: This is a male patient, 3 years 5 months old, with a history of food allergy with chronic abdominal pain, diarrhea and growth retardation. Chronic diarrhea was approached. RESULTS: With clinical findings of inflammatory bowel disease and histopathological description of eosinophilic colitis, the association between these two pathologies is considered without leaving the possibility that the latter is an initial phase of inflammatory bowel disease. CONCLUSIONS: The treatment of patients with complicated eosinophilic colitis is similar to inflammatory bowel disease, clinical, endoscopic and histopathological follow-up of patients with eosinophilic colitis is required in the long term.
Subject(s)
Humans , Male , Child, Preschool , Inflammatory Bowel Diseases , Colitis , Diarrhea/diagnosis , Enterocolitis , Eosinophils , Food Hypersensitivity , Pediatrics , Colitis, Ulcerative , Abdominal Pain , Colon , Enteric Nervous System , Diarrhea, Infantile , Eosinophilia , Prescription Drug Overuse , Gastrointestinal Diseases , HospitalizationABSTRACT
Abstract Introduction: The prevalence and incidence of gastrointestinal food allergy has increased in recent years with high associated costs, but usually with a good prognosis; nonetheless, in Colombia, information is scarce. This study intends to describe demographic variables, symptomatology, clinical picture, nutritional status, management, and natural history of the disease, determine its prevalence in the Colombian pediatric population by age group, and describe its direct costs. Materials and methods: The study was conducted in three phases. In the first, we estimated the prevalence of the disease from the review of the RIPS and MIPRES databases between 2015 and 2019. Secondly, we checked the medical records selected per the inclusion and exclusion criteria for characterization and costs. Lastly, through a telephone survey, we asked about the current state of the disease and its resolution. Results: The estimated prevalence adjusted for underreporting was 0.04 % for the pediatric population and 0.148 % for those under five. The most frequent diagnoses were allergic proctocolitis (59.3 %) and secondary functional gastrointestinal disorders (13.9 %). The most frequent allergen was cow's milk protein. Early management is related to an excellent nutritional prognosis. Direct costs are mainly related to using formulas (92 %) and medical appointments (3.4 %); 89 % of parents consider that the food allergy will resolve over time. Conclusions: This retrospective study is the most extensive in Colombia, drawing local conclusions that may be compared with other countries.
Resumen Introducción: la prevalencia e incidencia de la alergia alimentaria gastrointestinal ha aumentado en los últimos años, con importantes costos asociados, pero usualmente de buen pronóstico; sin embargo, en Colombia la información es escasa. Los objetivos del presente estudio son describir variables demográficas, sintomatología, clínica, estado nutricional, manejo e historia natural de la enfermedad; conocer su prevalencia en la población pediátrica colombiana por grupo etario, y describir sus costos directos. Materiales y métodos: el estudio se desarrolló en 3 fases: en la primera, se estimó la prevalencia de la enfermedad a partir de la revisión de las bases RIPS y MIPRES de 2015 a 2019; en la segunda, se revisaron las historias clínicas seleccionadas por los criterios de inclusión y exclusión para caracterización y costos; y en la tercera, por medio de una encuesta telefónica se interrogó el estado actual de la enfermedad y su resolución. Resultados: la prevalencia estimada ajustada por subregistro fue de 0,04 % para la población pediátrica y de 0,148 % para los menores de 5 años. Los diagnósticos más frecuentes fueron proctocolitis alérgica (59,3 %) y trastornos gastrointestinales funcionales secundarios (13,9 %). El alérgeno más frecuente fue la proteína de leche de vaca. El manejo temprano está relacionado con buen pronóstico nutricional. Los costos directos se relacionan principalmente con el uso de fórmulas (92 %) y consultas médicas (3,4 %). El 89 % de los padres considera la resolución de la alergia a través del tiempo. Conclusiones: este es el estudio retrospectivo más grande en Colombia, lo que permite conclusiones locales que pueden ser comparadas con otros países.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Costs and Cost Analysis , Food Hypersensitivity , Gastrointestinal Diseases , Population , Proctocolitis , Allergens , Medical Records , Surveys and Questionnaires , Retrospective Studies , MilkABSTRACT
Objetivo: A incidência das doenças alérgicas cresceu nas últimas décadas. Na tentativa de conter o aumento da alergia alimentar (AA) ao longo dos anos, estratégias de prevenção vêm sendo implementadas. Para promover um melhor entendimento dos dilemas que permeiam a introdução alimentar no primeiro ano de vida, esse artigo trata de uma revisão bibliográfica narrativa sobre a introdução dos alimentos complementares no primeiro ano de vida e possíveis associações com a prevenção primária da alergia alimentar. Fonte dos dados: Publicações relevantes foram pesquisadas nas bases de dados Cochrane Library, MEDLINE, PubMed, Guidelines International Network, National Guidelines Clearinghouse e revisadas recomendações do guia e do consenso nacional de alergia alimentar. Resultados: Estudos observacionais diversos e ensaios clínicos randomizados estão disponíveis, bem como recomendações publicadas por organizações científicas; no entanto, de qualidade variável. Foram consideradas as recomendações de diretrizes de prática clínica classificadas como de alta qualidade e publicações recentes ainda não categorizadas de forma sistemática em sua qualidade, mas internacionalmente reconhecidas como relevantes para a atenção primária. Conclusão: Até o momento, não há evidências consistentes de que a introdução precoce, antes dos 6 meses, dos alimentos alergênicos, contribua para a prevenção de alergia a alimentos na população geral.
Objective: The incidence of allergic diseases has increased in recent decades. In an attempt to contain the increase in food allergy (AA) over the years, prevention strategies have been implemented. To promote a better understanding of the dilemmas that permeate the introduction of food in the first year of life, this article deals with a narrative literature review on the introduction of complementary foods in the first year of life and possible associations with the primary prevention of food allergy. Data source: Relevant publications were searched in the Cochrane Library, MEDLINE, PubMed, Guidelines International Network, National Guidelines Clearinghouse, and revised recommendations from the national food allergy guide and consensus. Results: Several observational studies and randomized controlled trials are available, as well as recommendations. published by scientific organizations; however, of variable quality. Recommendations from clinical practice guidelines classified as high quality and recent publications not yet systematically categorized in their quality, but internationally recognized as relevant to primary care, were considered. Conclusion: To date, there is no consistent evidence that the early introduction, before 6 months, of allergenic foods contributes to the prevention of food allergy in the general population.
Subject(s)
Humans , Infant, Newborn , Infant , Food Hypersensitivity , Infant Food , Primary Health Care , Primary Prevention , Societies, Medical , Randomized Controlled Trials as Topic , Incidence , MEDLINE , Health Strategies , Guidelines as Topic , PubMed , Alkalies , Allergy and Immunology , Food , HypersensitivityABSTRACT
A alergia alimentar caracteriza-se por uma reação adversa a um determinado alimento, envolvendo um mecanismo imunológico. Uma das alergias mais comuns encontradas atualmente é a alergia a frutos do mar, a qual se baseia em uma hipersensibilidade a animais desse grupo. O objetivo desta pesquisa é identificar os desafios expostos na alimentação de alérgicos a frutos do mar e formular soluções para essa população baseadas em alimentos nutricionalmente substitutos. Sendo realizado em três etapas: investigação inicial, construção de conceitos e planejamento de uma ação com orientações nutricionais. De acordo com as dificuldades encontradas na alimentação dessa parcela populacional, realizaram-se diferentes preparações, com nutrientes como ômega-3, proteínas, vitaminas do complexo B, zinco, ferro, potássio, magnésio, iodo e selênio, os quais também são encontrados nos frutos do mar, a fim de evitar possíveis contaminações cruzadas e garantir seu aporte nutricional em alimentos substitutos. Foi possível concluir que os alérgicos aos frutos do mar não apresentam uma interferência significativa em sua qualidade de vida, tendo um impacto nutricional pequeno, visto que por meio da alimentação existem outras fontes, necessitando somente de alguns cuidados no dia a dia em virtude das consequências de uma possível contaminação.
Food allergy is characterized by an adverse reaction to a given food, involving an immunological mechanism. One of the most common allergies currently found is seafood allergy, which is based on hypersensitivity to animals in this group. The objective of this research is to identify the challenges exposed in the feeding of seafood allergies and formulate solutions for this population based on nutritionally substitute foods. Being carried out in 3 stages, initial investigation, construction of concepts and planning of an action with nutritional guidance. According to the difficulties encountered in feeding this portion of the population, different preparations were carried out, with nutrients such as: ômega-3, proteins, B vitamins, zinc, iron, potassium, magnesium, iodine and selenium. Which are also found in seafood. In order to avoid possible cross-contamination and ensure their nutritional intake in substitute foods. It was possible to conclude that seafood allergies do not present a significant interference in their quality of life, having a small nutritional impact, since through food there are other sources, requiring only some care on a daily basis due to the consequences of possible contamination.
Subject(s)
Humans , Shellfish , Food Hypersensitivity , Potassium , Quality of Life , Selenium , Vitamin B Complex , Vitamins , Zinc , Allergens , Nutrients , Diet , Eating , Iodine , Iron , MagnesiumABSTRACT
Primary health care providers are often confronted with patients describing adverse reactions to food. With a multiplex of differential diagnoses, it is essential to have a structured approach to these complaints. Just as allergies can have a negative impact on quality of life, inappropriate food allergy labelling can cause unnecessary distress and hardship for patients. Understanding the diagnostic approaches to adverse food reactions, alongside an appreciation of multidisciplinary collaboration, can assist the clinician in making appropriate decisions in the management of these patients. Keywords: food allergy; food hypersensitivity; food intolerance; allergy-focused history; allergy diagnosis.
Subject(s)
Diagnosis , Food Hypersensitivity , Food Intolerance , Nurse CliniciansABSTRACT
Objective: To translate the food allergy quality of life-parental burden (FAQL-PB) scale into Chinese and test its reliability and validity among the caregivers of children with food allergy. Methods: The caregivers of 222 children with food allergy were enrolled by convenient sampling from October 2020 to October 2021 in the Children's Hospital Affiliated to Chongqing Medical University. The forward-backward translation and cultural adaptation of the original FAQL-PB scale was performed in accordance with Brislin's model. Item analysis was used to select items. The validity of the questionnaire was analyzed with the item-level content validity and the exploratory factors analysis. And the internal consistency coefficient, split-half reliability and test-retest reliability were used to evaluate the reliability of the questionnaire. Results: The Pearson correlation coefficients of the scores between each item and total scale ranged from 0.72 to 0.88 (P<0.01). The item-level content validity index (I-CVI) ranged from 0.83 to 1.00, scale-level content validity index/universal agreement (S-CVI/UA) was 0.94, and scale-level content validity index/average (S-CVI/Ave) was 0.99. Exploratory factor analysis revealed that Chinese version of FAQL-PB scale could be classified into two dimensions: emotional distress and limitations on life, with the accumulative variance contribution rate of 74.08%. The Cronbach's α coefficient, split-half reliability coefficient and test-retest reliability of the Chinese version of FAQL-PB scale were 0.97, 0.98 and 0.71, respectively. Conclusion: The Chinese version of FAQL-PB scale is proved to be reliable and eligible, and can be used as a specific tool to investigate the quality of life in family of children with food hypersensitivity.
Subject(s)
Child , Humans , China , Food Hypersensitivity/diagnosis , Parents/psychology , Quality of Life , Reproducibility of ResultsABSTRACT
A maioria das respostas alérgicas a alimentos é mediada por IgE, que pode ser detectada para fins de diagnóstico da alergia alimentar. No entanto, para isso é necessário que alérgenos purificados estejam disponíveis para a elaboração dos diferentes formatos de ensaio, inclusive por microarray, que se constitui em uma ferramenta bastante útil para análise simultânea, e também para a identificação de reatividade cruzada. A esse respeito, é imprescindível ampliar a plataforma de alérgenos que possam ser empregados para a confecção de microarrays. Atualmente, alguns alimentos que constituem objeto de interesse na clínica em função do número de casos de alergia, e sobre os quais as informações a respeito dos alérgenos são escassas, são: abacaxi, mamão, mandioca e manga. Assim, o objetivo desse trabalho foi clonar, expressar e purificar proteínas potencialmente alergênicas de alimentos de importância regional. Após confirmadas por ensaios imunológicos, essas proteínas foram utilizadas na construção e validação de um microarray através de ensaios com os soros de pacientes alérgicos aos alimentos selecionados. Para atingir esse objetivo, foram selecionadas proteínas potencialmente alergênicas coincidentes, apontadas tanto pela similaridade com espécies taxonomicamente mais próximas, quanto pela técnica 2D Western Blotting acoplada à espectrometria de massas. Dezenove proteínas, sendo 4 de abacaxi, 5 de mamão, 6 de mandioca e 4 de manga, foram expressas em Pichia pastoris, purificadas e impressas em um microarray. Após incubar essas proteínas com os soros dos pacientes alérgicos aos alimentos estudados, 18 proteínas mostraram-se potencialmente alergênicas. Além disso, foi observada reatividade cruzada entre proteínas dos alimentos estudados e também em relação ao látex e outros frutos
The majority of allergic reactions to foods is IgE-mediated, which can be detected for the diagnosis of food allergy. However, purified allergens are necessary to produce different kinds of allergy tests, including microarray, which is a useful tool for simultaneous analysis, as well as for the identification of cross-reactivity. In this respect, it is essential to expand the platform of allergens to include them on microarrays. Nowadays, some foods that are object of interest in the clinical area in Brazil and it is necessary a further evaluation about their potential allergens, since there is a limited information about them, are: pineapple, papaya, cassava and mango. Therefore, the aim of this study was cloning, expressing and purifying potentially allergenic proteins of important Brazilian foods. After confirmed by immunological tests, these proteins were used in microarray production and validation by assays with sera from allergic patients to the selected foods. Achieving this goal, matching potentially allergenic proteins were selected, which were identified by comparison among taxonomically closer species (in silico) and 2D Western Blotting coupled with Mass Spectrometry. Nineteen proteins: 4 from pineapple, 5 from papaya, 6 from cassava and 4 from mango were expressed in Pichia pastoris, purified and printed on a microarray. After incubating those proteins with sera from allergic patients to the selected foods, 18 proteins were detected as potentially allergenic. In addition, cross-reactivity was observed among the proteins from the studied foods, and also regarding to the latex and other fruits
Subject(s)
Humans , Male , Female , Allergens/analysis , Cloning, Organism/instrumentation , Microarray Analysis/classification , Food , Food Hypersensitivity/diagnosis , Mass Spectrometry/methods , Blotting, Western/methods , Validation Study , Fruit/adverse effects , Hypersensitivity/complicationsABSTRACT
La alergia alimentaria se ha venido incrementando a nivel mundial, afectando alrededor del 1,5 % a 2,5 % de los adultos y 6 % de los niños, y tiene un gran impacto en la calidad de vida de los pacientes y sus cuidadores, debido a las dietas de restricción. Los alérgenos más prevalentes son la leche, el huevo, el trigo, la soja, los frutos secos, el maní, el pescado y los mariscos. Las leguminosas mejor estudiadas son el maní y la soja; otras leguminosas como las lentejas, garbanzos y arvejas representan la quinta causa de alergia alimentaria en el área mediterránea, en Turquía y en la India, siendo menos prevalentes en otras áreas geográficas. La alergia a las leguminosas es una entidad infrecuente en Colombia, se desconoce la prevalencia en el país. Describimos los primeros dos casos de anafilaxia por lentejas reportados en el país. Ambos pacientes menores de 18 años, con reacciones adversas tras la ingesta de leguminosas, en las cuales se demuestra alergia mediada por IgE a las lentejas y además sensibilización en el primer caso a las arvejas y garbanzos, y en el segundo caso a los frijoles. Diferentes datos sobre la prevalencia se han descrito en varias áreas geográficas, siendo mayor en países con dietas mediterráneas. Las reacciones mediadas por IgE suelen aparecer incluso con el alimento altamente cocido, debido a la termo-estabilidad de las proteínas. La reactividad cruzada más frecuente se relaciona con los garbanzos y las arvejas
Food allergy has been increasing worldwide. Affects around 1.5% to 2.5% of adults and 6% of children, and has a great impact on the quality of life of patients and their caregivers, due to restricted diets. The most prevalent allergens are milk, egg, wheat, soy, tree nuts, peanuts, fish and shellfish. The best studied legumes are peanuts and soybeans; other legumes such as lentils, chickpeas and peas represent the fifth cause of food allergy in the Mediterranean area, Turkey and India, being less prevalent in other geographical areas. Allergy to legumes is not common in Colombia, the prevalence in the country is unknown. We describe the first two cases of legumes anaphylaxis reported in the country. Both patients were under 18 years of age, with adverse reactions after ingesting legumes, in which IgE-mediated allergy was demonstrated; in the first case to lentils, peas and chickpeas, and in the second case, to lentils and beans. Different data on prevalence have been described in various geographical areas, being higher in countries with Mediterranean diets. IgE-mediated reactions usually appear even with highly cooked food, due to the thermo-stability of proteins. The most frequent cross-reactivity is related to chickpeas and peas