Allergic enteritis in children

Abstract

The gastrointestinal form of food allergy is very common in children. The most frequently observed types are allergic proctitis and proctocolitis. In most cases the symptoms subside within the first 2 months of life. The babies seem healthy, and the only abnormality is a small amount of blood in stool. Symptoms can also include small intestine inflammation and colitis. Patients may present with irritability, abdominal pain, flatulence, colic, postprandial vomiting, chronic diarrhoea, and hindered physical development. The diagnosis of allergic enteritis is based on the clinical examination and the results of additional tests including an endoscopy of the lower digestive tract with histopathological assessment. Cow’s milk proteins are the most common nutrition proteins responsible for the development of the symptoms of allergic enteritis. The most essential method of treating allergic enteritis is the elimination diet. The symptoms should subside within 1–2 weeks from the beginning of the diet.

CCR8 leads to eosinophil migration and regulates neutrophil migration in murine allergic enteritis

“…There is increasing evidence that neutrophils play an important role in the pathogenesis of allergic inflammation by mediating direct tissue injury or by releasing pro-inflammatory mediators 40 . Increased neutrophil numbers have also been detected in AE patients 5 . The potential of CCR8 antagonists has been considered to treat allergic asthma, since several studies have shown a role for CCR8 in the recruitment of Th2 cells and in the development of inflammation in murine models of allergic asthma 22,29,41 .…”

“…Food allergy causes clinical symptoms systemically and/or locally in cutaneous, respiratory, ocular, and gastrointestinal tissues 1–3 . Gastrointestinal forms of food allergy, which include allergic enteritis and colitis, are observed most frequently in pediatric patients with cow’s milk, or soy allergy, and also in adult patients allergic to other foods, including eggs of hens and wheat 4,5 . Biopsies have shown varying degrees of villous atrophy, tissue edema, crypt abscess formation, and eosinophil infiltration in the inflamed tissues of patients with allergic enteritis and colitis 6 .…”

Mast cells partly contribute to allergic enteritis development: Findings in two different mast cell‐deficient mice

“…To the Editor, Allergic enteritis (AE) is a gastrointestinal form of food allergy. 1 Compared with other clinical phenotypes of allergy, the pathomechanisms of AE have not been elucidated. In this study, we provide evidence, based on the studies of two mast cell-deficient mouse strains (KIT (W−sh/W−sh) bearing the W-sash (W(sh)) inversion is produced by innate lymphoid cells (ILC)2, supporting their capacity to protect against helminthic infections in the intestines.…”

“…FACS analysis showed that KIT W−sh/W−sh mice had reduced numbers of both eosinophils (CD45 + CD11b + SiglecF + cells) and neutrophils (CD45 + CD11b + SiglecF − Ly6G + cells), whereas Cpa3 Cre/+ mice had reduced eosinophils, but not neutrophils, in intestinal tissues (Figures2A and S2A-B).The W-sh mutation broadly affects c-Kit expression in myeloid precursor cells and increases granulocytic myeloid-derived suppressor cells, 2 which may contribute to reduced neutrophil accumulation and inflammation in KIT W−sh/W−sh mice. Importantly, both mast cells and eosinophils are observed in biopsy specimens upon microscopic inspection in most patients with AE 1. Yagi et al3 showed that the presence of neutrophils in intestinal biopsies is an indicator of a severe course of AE.…”

Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol

“…Gross rectal bleeding should resolve within 72–96 h, but the total resolution of symptoms takes 1–2 weeks from the beginning of the diet. 6 …”