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Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol
Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol
- Source :
- The World Allergy Organization Journal, World Allergy Organization Journal, Vol 13, Iss 10, Pp 100471-(2020)
- Publication Year :
- 2020
- Publisher :
- World Allergy Organization, 2020.
-
Abstract
- Food protein-induced allergic proctocolitis (FPIAP) is a condition characterized by inflammatory changes in the distal colon in response to one or more foreign food proteins because of immune-mediated reactions. FPIAP prevalence estimates range widely from 0.16% in healthy children and 64% in patients with blood in stools. In clinical practice, FPIAP is diagnosed when patients respond positively to the elimination of a suspected triggering food allergen. Nevertheless, significant proportions of infants get misdiagnosed with IgE mediated allergy and undergo unnecessary dietary changes. Diagnosis is based on clinical symptoms, a good response to an allergen-free diet and the recurrence of symptoms during the "allergy challenge test". Sometimes clinical features may be non-specific and the etiology of rectal bleeding in childhood may be heterogeneous. Therefore, it is crucial to exclude a variety of other possible causes of rectal bleeding in the pediatric age group, including infection, anal fissure, intestinal intussusception and, in infants, necrotizing enterocolitis and very early onset inflammatory bowel disease. The diagnostic workup includes in those cases invasive procedures such as sigmoidoscopy and colonoscopy with biopsies. The high prevalence of FPIAP contrasts with the lack of known information about the pathogenesis of this condition. For this reason and due to the absence of a review of the evidence, a literature review appears necessary to clarify some aspects of allergic colitis. The aim of the review is to fill this gap and to lay the foundations for a subsequent evidence-based approach to the condition.
- Subjects :
- lcsh:Immunologic diseases. Allergy
Pulmonary and Respiratory Medicine
Allergy
Pediatrics
medicine.medical_specialty
Immunology
Colonoscopy
allergic colitis
eosinophils
rectal bleeding
Inflammatory bowel disease
Article
Pathogenesis
Rectal bleeding
03 medical and health sciences
0302 clinical medicine
medicine
Immunology and Allergy
030223 otorhinolaryngology
Anal fissure
medicine.diagnostic_test
business.industry
Sigmoidoscopy
medicine.disease
Eosinophils
030228 respiratory system
Allergic colitis
Necrotizing enterocolitis
Etiology
lcsh:RC581-607
business
Subjects
Details
- Language :
- English
- ISSN :
- 19394551
- Volume :
- 13
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The World Allergy Organization Journal
- Accession number :
- edsair.doi.dedup.....4a9ca449a151708f6d33055374808450