Food Allergy Prevalence in Salvadoran Schoolchildren Estimated by Parent-Report.

The prevalence of food allergy (FA) has not been estimated at a population level in Central American countries and, consequently, the magnitude and relevance of the problem in the Central American region remains unknown. Thus, our aim was to evaluate the parent-reported prevalence of FA in a population of schoolchildren from the Central American country El Salvador. A Spanish version of a structured questionnaire was utilized. Five hundred and eight (508) parents returned the questionnaire with valid responses (response rate, 32%). The estimated prevalence rates (95% CI) were: adverse food reactions 15.9 (13.0⁻19.3), "perceived FA, ever" 11.6 (9.1⁻14.6), "physician-diagnosed FA, ever" 5.7% (4.0⁻8.0), "immediate-type FA, ever" 8.8% (6.6⁻11.6), "immediate-type FA, current" 5.3% (3.6⁻7.6), and anaphylaxis 2.5% (1.5⁻4.3). The most common food allergens were milk (1.7%), shrimp (1.3), chili (0.7%), chocolate (0.7%), and nuts (0.3%). Most of the "food-dependent anaphylaxis" cases (60.5%) sought medical attention, but only one case reported the prescription of an epinephrine autoinjector. Mild and severe FA cases are not uncommon among Salvadoran schoolchildren and both the prescription of epinephrine autoinjectors by healthcare personnel and the use of the autoinjectors by anaphylactic individuals should be encouraged.

Assessment of the Sensitizing Potential of Proteins in BALB/c Mice: Comparison of Three Protocols of Intraperitoneal Sensitization.

Most food allergy cases are associated with a limited group of allergens. This could be attributed to an increased ability of some foods to sensitize and trigger allergic reactions. However, there are no validated animal models to evaluate the sensitizing or allergenic potentials of proteins. Our aim was to evaluate three protocols of adjuvant-free intraperitoneal sensitization that differ in the time points for sample collection (days 14, 28 and 35 from beginning of the sensitization) and also in the number of immunizations (2, 5 and 3, respectively). Ovalbumin (OVA; 0.05 mg), cow milk proteins (CMP; 0.025, 0.05 and 0.25 mg), and potato acid phosphatase (PAP; low allergenic protein; 250.0 mg) were administered intraperitoneally (ip) to BALB/c mice (n = 4⁻6) and the protein-specific IgE and IgG antibody responses were evaluated using ELISA. Additional serum protein-specific IgE antibodies evaluations were carried out after IgG depletion. Anti-OVA IgE antibodies were detected in mice from all three protocols. The responses were higher in the group of mice that underwent the 28-day protocol than in those that underwent the 14- or 35-day protocols (p < 0.01 and p < 0.05, respectively). Anti-CMP IgE antibodies were detected in both the 14- and 28-day protocols, but the response was higher in the group that underwent the 28-day protocol (p < 0.001). The anti-CMP IgE antibody response detection was improved after serum IgG depletion (p < 0.001). Anti-PAP IgE antibodies were not detected. Mice with undetectable serum levels of protein-specific IgE triggered anti-OVA, -CMP, and -PAP IgG responses. An adjuvant-free 28-day protocol with five ip immunizations seems appropriate for evaluation of the inherent sensitizing or allergenic capacity of the studied proteins. Reproducible results were obtained utilizing the BALB/c mouse strain. Inter-laboratory studies including a larger number of proteins should be carried out to validate this model.

A retrospective review of rattlesnake bites in 100 children.

BACKGROUND: A retrospective review of clinical features and treatment of children hospitalized for rattlesnake bite. METHODS: One hundred clinical records were reviewed. Variables included: age, gender, season of the year, signs, symptoms, poisoning grade, complications, treatment and sequelae. RESULTS: Fifty-nine percent were males and 37% were less than 5 years of age; 87% occurred in rural areas; 63% of the snakebites occurred during the summer, of them, 39% occurred within the perimeter of the domicile and 8% within the home. Sixty-seven percent of children bitten by snakes reached the second degree of envenomation. During the first period (1977-1996), treatment for intoxication included treatment with polyvalent equine anti-snake venom serum. During the second period (1997-2014, a polyvalent polyclonal horse anti-snake venom F(Ab) was used. The second period hospitalization time was reduced to 3.9 days (P<0.0001). Hematological complications dominated during the first period (P=0.093) with wound infections occurring in 26% of the cases, neurological symptoms in 24 %, fasciotomy in 6% and mortality in 1%. The second degree poisoning was more frequent and was more severe in 7% of the patients. It was determined that the best treatment for snakebite was F(Ab') 2 therapy. Mortality occurred in 1% of the cases. CONCLUSIONS: Rattlesnake (Crotalus sp.) bite, in Mexico is less frequent as compared to other crotalidae species. The hematological complications are more frequent. We did not observe any recurrent phenomenons.

[Detection of Helicobacter pylori in children and adolescents using the monoclonal coproantigen immunoassay and its association with gastrointestinal diseases]. / Detección de Helicobacter pylori en niños y adolescentes mediante coproantígeno monoclonal y su asociación con gastropatías.

BACKGROUND: Infection by Helicobacter pylori (H. pilory) affects 50% of the world population. Simple methods for its detection are now available. OBJECTIVES: To identify H. pylori by using a monoclonal coproantigen technique in paediatric patients, and to determine its association with gastrointestinal diseases. MATERIALS AND METHODS: The study included a total of 110 subjects aged 1 to 18 years. The study variables included: Family history of gastrointestinal disease, age, gender, gastrointestinal symptoms, as well as apparently healthy (asymptomatic) subjects. The monoclonal coproantigen test was performed on stool samples. Two groups, I symptomatic (n=29), and II asymptomatic (n=81) were compared using parametric and non-parametric statistics. RESULTS: Of the 110 patients, 59 (54%) were male. The relationship between a family history of gastritis and a positive for H. pylori, was significant for mothers (p<0.0005), fathers (p<0.0001), and paternal grandfathers (p<0.0001). It was significant for gastric cancer in maternal grandparents (p<0.0178) and paternal grandparents (p<0.0092). The monoclonal coproantigen test was positive in 31 (28.2%) of the subjects. All were positive in group I, and only 2 in group II. A significant positive association was observed between H. pylori and various signs and symptoms, such as epigastric pain (p<0.001), recurrent peri-umbilical pain (p<0.001), bloating (p=0.016), heartburn (p=0.0007), nausea (P=0.0061), diarrhoea (p=0.0389), and constipation (p=0.0019). CONCLUSIONS: H. pylori detection, was positive in 28% of both groups, and showed significant relationships with family gastrointestinal diseases and gastrointestinal symptoms.

Syneresis in Gels of Highly Ferulated Arabinoxylans: Characterization of Covalent Cross-Linking, Rheology, and Microstructure.

Arabinoxylans (AXs) with high ferulic acid (FA) content (7.18 µg/mg AXs) were cross-linked using laccase. Storage (G') modulus of AX solutions at 1% (AX-1) and 2% (AX-2) (w/v) registered maximum values of 409 Pa and 889 Pa at 180 min and 83 min, respectively. Atomic force microscopy revealed the grained and irregular surface of the AX-1 gel and the smoother surface without significant depressions of the AX-2 gel. Cured AX gels exhibited a liquid phase surrounding the samples indicating syneresis. The syneresis ratio percentage (% Rs) of the gels was registered over time reaching stabilization at 20 h. The % Rs was not significantly different between AX-1 (60.0%) and AX-2 (62.8%) gels. After 20 h of syneresis development, the dimers of the FA in the AX-1 and AX-2 gels significantly increased by 9% and 78%, respectively; moreover, the trimers of the FA in the AX-1 and AX-2 gels, by 94% and 300%, respectively. Scanning electron microscopy showed that, after syneresis stabilization, AX gels presented a more compact microstructure. Syneresis development in the gels of highly ferulated AXs could be related to the polymer network contraction due to the additional formation of dimers and trimers of the FA (cross-linking structures), which may act like a "zipping" process, increasing the polymer chains' connectivity.

[Indicators of obsolescence of the medical literature in a mexican pediatric journal]. / Indicadores de obsolescencia de la literatura médica en una revista pediátrica mexicana.

INTRODUCTION: Obsolescence is the decrease of the validity of the information in time and is known as literature aging. OBJECTIVES: To analyze the obsolescence of the literature of original articles published in 10 years in a Mexican pediatric journal. MATERIAL AND METHODS: Articles published in the Clinical Bulletin of Sonora Children's Hospital (BCHIES) were analyzed. The variables were: year, volume, number, percentage of original articles, reference year, total of references per article, operational and file; articles citations and self-citations, Price Indices, Burton-Kebler and Brookes, half-life, and aging factor. RESULTS: The 87 original articles (37%) contained 1,726 references, and the average was 19.8 per article; operational references were 398 (23%) and the file references, 1,287 (74.5%). There were 30 (34.4%) citations to articles, and self-citations were 19 (21%), half-life, 13.2 years; the aging factor was 0.86, the annual loss of income was 14%. CONCLUSIONS: The percentage of original articles from the BCHIES is close to 40%, likely to improve, and in the literature archive, the aging factor reversed.

In vitro degradation of covalently cross-linked arabinoxylan hydrogels by bifidobacteria.

Arabinoxylan gels with different cross-linking densities, swelling ratios, and rheological properties were obtained by increasing the concentration of arabinoxylan from 4 to 6% (w/v) during oxidative gelation by laccase. The degradation of these covalently cross-linked gels by a mixture of two Bifidobacterium strains (Bifidobacterium longum and Bifidobacterium adolescentis) was investigated. The kinetics of the evolution of structural morphology of the arabinoxylan gel, the carbohydrate utilization profiles and the bacterial production of short-acid fatty acid (SCFA) were measured. Scanning electron microscopy analysis of the degraded gels showed multiple cavity structures resulting from the bacterial action. The total SCFA decreased when the degree of cross-linking increased in the gels. A slower fermentation of arabinoxylan chains was obtained for arabinoxylan gels with more dense network structures. These results suggest that the differences in the structural features and properties studied in this work affect the degradation time of the arabinoxylan gels.

Revisión de la enfermedad de Kawasaki en México, desde la perspectiva de las publicaciones médicas (enero de 1977 a mayo de 2012) / A review of Kawasaki disease, a perspective from the articles published in Mexico since January 1977 to May 2012

La enfermedad de Kawasaki fue descrita en 1967 por Tomisu Kawasaki. Afecta principalmente a los niños entre uno y 5 años, y se manifiesta con fiebre y vasculitis de vasos medianos que pueden conducir a diversas complicaciones cardiovasculares, tales como aneurismas en las arterias coronarias, miocarditis, daño valvular, derrame pericárdico e infarto del miocardio; eventualmente involucra otros órganos. La etiología aun no es bien conocida, como tampoco lo son los mecanismos patogénicos exactos, pero existen notables avances. Cuando los signos y síntomas clínicos son identificados tempranamente y los niños reciben tratamiento con gammaglobulina y aspirina, la evolución suele ser satisfactoria y pueden evitarse las afecciones coronarias y otras complicaciones. La enfermedad de Kawasaki no se registra frecuentemente en México.

Kawasaki disease was described in 1967 by Tomisu Kawasaki. It affects children aged between one and 5 years, and it evolves with fever and small vessel vasculitis, which leads to cardiovascular complications, including coronary aneurisms, myocarditis, valve injuries, pericardial effusion and myocardial infarction; eventually involving many others organs. The etiology actually is not well known, as the exactly pathogenic mechanisms; however, now there are important advances. If the clinical signs and symptoms are identify early and the children received treatment with aspirin and intravenous immunoglobulin, the patients evolves without sequels. The Kawasaki disease is an infrequent disease in Mexico.

[A review of Kawasaki disease, a perspective from the articles published in Mexico since January 1977 to May 2012]. / Revisión de la enfermedad de Kawasaki en México, desde la perspectiva de las publicaciones médicas (enero de 1977 a mayo de 2012).

Kawasaki disease was described in 1967 by Tomisu Kawasaki. It affects children aged between one and 5 years, and it evolves with fever and small vessel vasculitis, which leads to cardiovascular complications, including coronary aneurisms, myocarditis, valve injuries, pericardial effusion and myocardial infarction; eventually involving many others organs. The etiology actually is not well known, as the exactly pathogenic mechanisms; however, now there are important advances. If the clinical signs and symptoms are identify early and the children received treatment with aspirin and intravenous immunoglobulin, the patients evolves without sequels. The Kawasaki disease is an infrequent disease in Mexico.

[Stevens-Johnson syndrome and toxic epidermal necrolysis in children]. / Síndrome de Stevens-Johnson y necrólisis epidérmica tóxica en los niños.

The Stevens-Johnson syndrome (SJS) and the toxic epidermal necrolysis (TEN) are clinical conditions manifesting as adverse cutaneous reaction to drugs in majority of cases, constituting the same clinical spectrum, differing only in the severity of epidermolysis; both conditions are distinguished by their severity and extensiveness of skin lesions; it can also involve mucous membranes of eyes, respiratory, digestive and urogenital tracts. Two per 1,000,000 are affected annually, among them approximately 20% are children and both of them are considered as potentially fatal medical emergency conditions. Even though the condition was described 89 years ago, until now the exact pathophysiology has not been completely explained. An immune-mediated mechanism has been implicated in its origin, which involves cytotoxic lymphocytes, cytokines, Fas-ligand in keratinocyte apoptosis; genetic makers also has been identified in some racial groups (HLA-B*1520, HLA-B*5801) in relationship with specific susceptibility to certain drugs such as carbamazepine, allopurinol. In children there are no uniform criteria for classification of the skin lesions, neither for the treatment, however recently the authors describe better response of the patients with use intravenous immunoglobulin (IGIV).

Borreliosis, fiebre recurrente causada por espiroquetas. Informe de un caso / Borreliosis: recurrent fever due to spirochetes. Case report

Introducción. Las fiebres recurrentes son un grupo complejo de enfermedades causadas por diversas espiroquetas del género Borrelia, que el hombre adquiere por piquetes de piojos o garrapatas. El propósito de este trabajo es presentar un caso con esta enfermedad. Caso Clínico. Paciente femenino de 12 años de edad, que presentó inicialmente fiebre, cefalea, adenitis cervical y exantema toracoabdominal. La fiebre fue recurrente durante tres meses, con periodos 3 a 5 días e intervalos afebriles de 15 a 21 días. Los resultados de los exámenes de laboratorio fueron negativos para los anticuerpos anti Borrelia burgdorferi. En el frotis de sangre se identificaron espiroquetas. Fue tratada con diversos esquemas de antibióticos y, finalmente, con doxiciclina. Su evolución fue satisfactoria, y tres meses después aún se encuentra asintomática. Conclusiones. En el presente caso se consideró prudente, entre los diagnósticos diferenciales, incluir la posibilidad de fiebre recurrente atribuida a espiroquetemia. La dificultad para establecer el diagnóstico nos muestra la importancia de tener en mente este tipo de infecciones.

Background. Relapsing fever is a complex group of diseases caused by spirochetes of the genus Borrelia transmitted to humans by lice or ticks. The purpose of this study is to present a case of relapsing fever. Case report. A 12-year-old girl with no relevant clinical history was admitted with fever, headache, cervical adenitis, and thoracoabdominal exanthema. She had relapsing fever for 3 to 5 days with 15- to 21-day-intervals of apyrexia during the past 3 months. Laboratory exams were normal or negative including antibodies for Borrelia burdorferi. Peripheral blood smear showed spirochetes. She was treated with various antibiotics and finally doxycycline was added with a good response. The patient is asymptomatic and without sequelae 3 months after treatment. Conclusion. In the case we reported, relapsing fever due to spirochetemia was made during the differential diagnosis. Due to the difficulty in identification, it is important to have a clinical suspicion of this type of infection.

Incidencia y evolución de la enfermedad de Kawasaki en México: [revisión] / Incidence and course of Kawasaki disease in Mexico: [review]

Introducción: La enfermedad de Kawasaki (EK) afecta a niños entre 1 y 5 años de edad, se manifiesta con fiebre y vasculitis en diversos órganos; en el corazón daña las arterias coronarias. Objetivos: Analizar la EK a través de lo publicado en México entre 1977 y 2010. Material y métodos: De los artículos publicados de EK, se consideraron las bases clínicas para el diagnóstico, alteraciones cardíacas, estudios de laboratorio y por imágenes, complicaciones, tratamiento evolución y mortalidad; se utilizó estadística descriptiva. Resultados: En 155 casos la edad varió entre 3 y 5 años, la proporción de sexo masculino fue 3.3:1; por ecocardiografía se encontraron aneurismas coronarios en 61 niños (39%), miocarditis en 19 (12%), derrame pericárdico en 9 (5.8%), insuficiencia aórtica en 4, insuficiencia mitral en 5; los hallazgos de laboratorio más comunes fueron leucocitosis, neutrofilia, trombocitosis, elevación de VSG y de proteína C-reactiva. Cuarenta y dos pacientes fueron tratados con aspirina; recibieron gammaglobulina y aspirina 104 (67%); dipiridamol30 (19%); en menos de 3% de los casos se utilizó prednisona y metilprednisolona. Tres meses después de su egreso hospitalario 124 niños (80%) no presentaron secuelas; 11 tuvieron aneurismas gigantes, y 8, infarto del miocardio; en 3 se hizo cirugía de revascularización; 3 fallecieron (1.9%). Conclusiones: En México, conforme se ha utilizado tempranamente gammaglobulina y aspirina, han disminuido las lesiones coronarias debidas a la enfermedad de Kawasaki.

Giardia lamblia infection and its implications for vitamin A liver stores in school children.

BACKGROUND: Vitamin A deficiency (VAD) is a nutritional problem affecting the health of people in developing countries because VAD compromises innate and adaptive immunity, increasing a person's predisposition toward infectious diseases. In addition, a high prevalence of infectious diseases continues to be a problem in developing countries, including Giardia lamblia. G. lamblia may be related to VAD because of its ability to change the intestinal architecture, thereby compromising the absorption of vitamin A. The aim of this study was to evaluate the effect of giardiasis on serum retinol levels and vitamin A liver stores in school children. METHODS: Thirty Giardia-infected school children participated in this study. Vitamin A liver stores were evaluated with the modified relative dose response (MRDR) technique, and antiparasitic treatment was administered. In addition, anthropometric and dietary data were collected. RESULTS: According to anthropometric indicators (age-appropriate Z scores for weight, height and body mass index) and daily vitamin A intake, the children had a normal nutritional status. Although the mean serum retinol levels did not change significantly after treatment for Giardia (p > 0.05), the MRDR values showed significant improvement (p < 0.002). CONCLUSION: Giardiasis not only compromises the vitamin A status through intestinal malabsorption, it also causes profound mobilization of liver retinol stores.

Utilidad de segunda biopsia de ganglio linfático con informe previo de hiperplasia linfoide reactiva en niños / Usefulness of second lymph node biopsy with a prior report of reactive lymphoid hyperplasia in pediatric patients

Introducción: En niños con ganglios linfáticos superficiales aumentados de tamaño se debe tener cuidado en definir quién requerirá biopsia. El objetivo de esta investigación fue analizar la utilidad de la biopsia de ganglio linfático superficial en el diagnóstico pediátrico. Métodos: De los informes histopatológicos de 364 biopsias de niños y adolescentes se consideró edad, sexo, tiempo de evolución de la adenomegalia, área anatómica, estudios de laboratorio y gabinete, y diagnósticos histopatológicos. Para el análisis estadístico se utilizaron pruebas estadísticas paramétricas y no paramétricas. Resultados: 211 pacientes masculinos (57.9 %) y 153 femeninos (42.0 %); el grupo entre uno y seis años representó 50.8 %, el tiempo promedio de evolución fue de cinco meses, el sitio anatómico predominante fue la región cervical. En 46.9 % se trató de hiperplasia linfoide reactiva seguida de neoplasias (24 %) y procesos granulomatosos (14.5 %); en 14.6 % se incluyeron infecciones diversas; en 95 pacientes con adenopatía en sitios de alarma, 29 eran oncológicos. El coeficiente de determinación de Spearman (R2 = 0.3485) indicó especificidad de patología en esas áreas, aunque la mayoría de los diagnósticos fue de ganglios en regiones diversas; prueba de Fisher con p < 0.0001. En 25 niños con hiperplasia linfoide reactiva en primer estudio, en segunda biopsia se estableció diagnóstico; la probabilidad binomial fue p = 0.0493, con 75 % de certeza y prueba de χ2 con p = 0.0512. Conclusiones: Los ganglios en regiones de alarma indican probabilidad para encontrar enfermedad; en crecimiento persistente con informe inicial de hiperplasia linfoide reactiva debe considerarse segunda biopsia pues existe probabilidad > 75 % de establecer la causa.

BACKGROUND: Physicians in daily practice frequently attend children who present an increase in lymph node size. Care should be taken to determine which children require biopsy. Our objective was to analyze the usefulness of the peripheral lymph node biopsy in pediatric diagnosis. METHODS: We reviewed histological reports of 364 lymph node biopsies. Variables were age, sex, lymphadenopathy evolution time, laboratory and imaging studies, and histopathology diagnoses. Parametric and nonparametric tests were used. RESULTS: There were 211 males (57.9 %) and 153 females (42.0 %), the 1- to 6-year age group included 50.8% of cases. Average disease-evolution time was 5 months, and the predominant anatomic site was the cervical region. Histological report was reactive lymphoid hyperplasia (RLH) in 46.9%, followed by neoplasms in (24%), and granulomas (14.5%). Other diagnoses and normal lymph nodes represented 14.6 %. Of the 95 patients with high-risk lymphadenopathy, 29 cases had oncological diagnoses. Spearman coefficient was R(2) = 0.3485. To obtain a specific diagnosis indicates the probability of disease in lymph nodes of risk areas. However, the majority of the diagnoses were obtained from lymph nodes in different areas (Fisher's test, p <0.001). In 25 children with RLH, the binominal probability of diagnosis in the second biopsy was p = 0.0493. There was a >75% chance for detecting disease. CONCLUSIONS: Peripheral lymph nodes in high-risk regions indicate probability relationship for determining disease. In persistent lymphadenopathy with an initial report of RLH, it is important to consider a second biopsy with high probability for obtaining a specific diagnosis.

Adenoma cortical suprarrenal, hipercortisolismo, cardiomiopatía y bazo accesorio intrapancreático en un lactante / Cortical adrenal adenoma, hypercortisolism, cardiomyopathy, and intra-pancreatic accessory spleen in a 3-month-old infant

Introducción. El síndrome de Cushing es el resultado de concentraciones elevadas de glucocorticoides en la circulación, su presentación en lactantes es poco común. Caso clínico. Presentamos un caso de hipercortisolismo endógeno en un niño de 3 meses de edad, secundario a un adenoma suprarrenal congénito. El paciente manifestó polifagia, aumento de peso y alteraciones en el patrón del sueño; al examen físico se observó hirsutismo frontal, cara en "luna llena", abultamiento visible en región cervico-dorsal ("giba de búfalo"), hipertensión arterial; el cortisol plasmático fue de 163 pg/dL, y el ultrasonido abdominal reveló tumoración suprarrenal izquierda. Durante el período de hospitalización, el niño cursó con dificultad respiratoria y taquicardia; la radiografía de tórax mostró cardiomegalia. Después de un procedimiento quirúrgico simple (venodisección), el paciente desarrolló choque cardiogénico y falleció. En la autopsia se encontró, además de la tumoración suprarrenal, cardiomiopatía hipertrófica y bazo accesorio intrapancreático. Conclusión. La causa más común del síndrome de Cushing en todos los grupos de edad, excepto en lactantes, es hipercortisolismo exógeno; la asociación de patologías aquí presentadas es muy raro.

Introduction. Cushing syndrome is associated with high levels of glucocorticoids in the circulation and is infrequently in infants. Case report. We present a case of congenital cortical adrenal adenoma-associated endogenous hypercortisolism in a 3-month-old infant. The patient manifested polyphagia, weight gain, and changes in sleep patterns. During physical examination we found a full-moon face, bulkiness in the cervico-dorsal "buffalo-hump" region, high blood pressure, and serum cortisol of 163 pg/dL. Abdominal ultrasound revealed left adrenal tumor. During hospitalization, the patient experienced respiratory difficulty and tachycardia, and thoracic X- ray revealed cardiomegaly. After a simple surgical procedure (venous dissection), the patient developed cardiogenic shock and died. At autopsy, adrenal tumor was found in addition to hypertrophic cardiomyopathy and intrapancreatic accessory spleen. Conclusion. The most common cause of Cushing syndrome in all age groups is exogenous hypercortisolism, except in infants. The associated pathologies described in this article are rare.

Bovine milk caseins and transglutaminase-treated cereal prolamins are differentially recognized by IgA of celiac disease patients according to their age.

The prevalence of celiac disease (CD) has increased worldwide, which could be related to some dietary proteins in infant regimens and/or new food processes, affecting CD-predisposed infants and older children or adults differentially. IgA reactivity to human and bovine caseins, as well as yogurt caseins and prolamins from wheat or maize breads, microbial transglutaminase (mTG)-treated or not, was evaluated in three patient groups: G1, <2 years old; G2, approximately 3 years old; and G3 >8 years old. Human caseins were not recognized by IgA, whereas IgA reactivity of G2 and G3 was higher to bovine milk caseins. Immunoreactivity of G1 to yogurt caseins was lower and comparable to controls, with no effects due to mTG treatment. However, mTG treatment increased reactivity of G3 to wheat and maize prolamins. IgA immunoreactivity of CD patients to caseins and mTG-treated or not prolamins was age-dependent, which could reflect a differential manifestation of the effects of such proteins on the intestinal barrier.