Crico‐pharyngeal spasm associated with cow milk protein allergy in infancy

Food Hypersensitivity and Otolaryngologic Conditions in Young Children

“…Of 11 patients who underwent esophageal biopsies, 4 (36%) had a histologic diagnosis of eosinophilic esophagitis, which also implies that a cellular‐mediated response may not always be through an eosinophilic pathway. Prior evidence suggests that non–IgE‐mediated immune reactions may occur at deeper structures in the intestinal tract that cannot be evaluated through mucosal biopsies and can have effects on motility and neurological pathways 14,15 . An interesting observation in our cohort of patients who had both upper endoscopy and flexible sigmoidscopy (n = 6) was that all had lymphonodular hyperplasia in the rectosigmoid region.…”

“…Prior evidence suggests that non-IgE-mediated immune reactions may occur at deeper structures in the intestinal tract that cannot be evaluated through mucosal biopsies and can have effects on motility and neurological pathways. 14,15 An interesting observation in our cohort of patients who had both upper endoscopy and flexible sigmoidscopy (n = 6) was that all had lymphonodular hyperplasia in the rectosigmoid region. A similar finding described by Gottrand and colleagues 17 was that of food allergy-induced bleeding from the lower intestine.…”

“…12 Dysphagia secondary to reduced laryngopharyngeal mechanoreceptor sensitivity can also, theoretically, be related to CMPA-associated GERD and laryngopharyngeal reflux. 13,14 Nonetheless, specific examination of the relationship between common food allergens and otolaryngologic conditions in young children has not been performed. Diagnosing CMPA in this patient population has been particularly difficult.…”

Non-IgE-Mediated Cow Milk Allergy Is Linked to Early Childhood Clusters of Commonly Seen Illnesses

“…A review of literature defining intestinal and extraintestinal manifestations of CMPA was also performed. 3,4,8,9,11,16,17 Both chart and literature review suggests a strong family association regarding food allergies. 19 Questions related to family history were restricted only to first-degree relatives of the study subject.…”

“…CMPA is a multisystem disorder that can present with gastrointestinal, cutaneous, and upper and lower respiratory syndromes. [8][9][10][11][12] Individually, many of these symptoms overlap with routine illnesses seen in the setting of well child visits.…”