BackgroundTo understand the clinical characteristics and the diagnostic procedures in pediatric patients with eosinophilic esophagitis and to evaluate the sensitivity of the patients to food and inhalant allergens. A cross-sectional study was performed in 35 children with eosinophilic esophagitis during the time period from January 2010 to January 2011. The clinical and epidemiological data were obtained using a questionnaire and medical chart analysis. The body mass index for age was used for the nutritional evaluation (via the Z score). The sensitivity to foods and inhalants was evaluated by performing a skin prick test and atopy patch test.ResultsPatients (35 in total, median age 10 years) with a diagnosis of eosinophilic esophagitis were evaluated. The most prevalent symptoms in the patients were vomiting (71.4%) and abdominal pain (51.4%). Endoscopic alterations were observed in 97.2% of the patients. A good nutritional state was observed in 82.8% of the children. The tests demonstrated the presence of food sensitivities and/or aeroallergens in 27 (77.1%) patients, whereas 8 (22.9%) patients did not test positive in any of the tests performed. Among the patients with positive tests, 24 (68.5%) exhibited sensitivity to aeroallergens and 16 (45.7%) were sensitive to foods. The comparison between the sensitive and insensitive groups displayed statistically significant results with respect to sex, symptom prevalence, and 24-hour esophageal pH monitoring.ConclusionsThe patients evaluated in this study displayed clinical characteristics of eosinophilic esophagitis similar to those reported in the literature. The sensitivity to foods determined by the tests was less than that observed in prior studies; however, a marked sensitivity to aeroallergens was observed. The different allergen sensitivity profiles observed in this study suggests that, similar to asthma, the eosinophiic esophagitis disease may exhibit several phenotypes.
Objective: To correlate the nutritional status with variables associated to the type of diet and feeding route of children and adolescents with spastic quadriplegic cerebral palsy (CP). Methods: This cross-sectional study included 28 patients aged ≤13 years old who presented a diagnosis of spastic quadriplegic CP and were followed by the nutrition team of the Outpatient Clinic for Special Patients of Hospital de Clínicas de Uberlândia - Universidade Federal de Uberlândia (HC-UFU), between July/2016 and January/2017. Consent forms were signed by the legal guardians. The nutritional status was evaluated and data on dietary complications food route and type of diet were collected. For the description of data, average and median values were used. Correlation was tested with Spearman’s index. Significance was set at p<0.05. Results: 75% of patients used alternative feeding routes (nasoenteral, catheter or gastrostomy), 57% were eutrophic. The most frequent complications were oropharyngeal dysphagia, reflux and intestinal constipation. No correlation was found between the occurrence of complications and the nutritional status. There was a positive correlation between the diet received and the patient’s nutritional status (0.48; p=0.01), i.e. individuals with adequate caloric and macronutrients intake had a better nutritional status. Conclusions: The results reinforce the need for continued nutritional guidance for the children’s parents/caregivers, as well as the choice of an adequate rout of feeding to each child by the multi-professional team, in order to contribute to improved nutritional status and adequate dietary intake.
Maple syrup urine disease (MSUD) is an inborn error of metabolism caused by an enzyme deficiency and leads to the accumulation of branched-chain amino acids (BCAAs), which are toxic to the body in high concentrations. Part of the treatment is based on dietary control and a reduced intake of BCAAs. The objective of this study was to describe the clinical condition, nutritional status and food consumption of patients with MSUD. Two patients diagnosed with MSUD were selected. Interviews and nutritional, body composition, and food consumption assessments were carried out. Energy, macronutrients, micronutrients, BCCAs, and fiber contents were estimate. All clinical data were obtained from medical records. Both patients showed manifestations of neuropsychomotor development delay with intellectual disability. Regarding nutritional status, one patient was overweight, and the other was underweight, with low functional capacity in both of them. A monotonous dietary pattern and a low intake of energy, proteins, vitamins, and minerals were observed, but there was a high consumption of BCAAs by one of the patients. Developmental and intellectual disabilities were observed besides the changes in nutritional status (underweight and overweight), low functional capacity, dietary inadequacies in terms of energy, macronutrients, and micronutrients, besides a monotonous food consumption pattern.
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