Diagnosis and treatment of pediatric food allergy: an update

Abstract

The prevalence of pediatric food allergy and anaphylaxis has increased in the last decades, especially in westernized countries where this emerging phenomenon was marked as a “second wave” of the allergic epidemic. Over recent years great advances have been achieved in the field of in vitro allergy testing and component-resolved diagnosis has increasingly entered clinical practice. Testing for allergen components can contribute to a more precise diagnosis by discriminating primary from cross-reactive sensitizations and assessing the risk of severe allergic reactions.The basic concept of the management of food allergy in children is also changing. Avoidance of the offending food is still the mainstay for disease management, especially in primary health care settings, but it severely affects the patients’ quality of life without reducing the risk of accidental allergic reactions. There is a growing body of evidence to show that specific oral tolerance induction can represent a promising treatment option for food allergic patients. In parallel, education of food allergic patients and their caregivers as well as physicians about anaphylaxis and its treatment is becoming recognized a fundamental need. International guidelines have recently integrated these new evidences and their broad application all over Europe represents the new challenge for food allergy specialists.

IgA deficiency: a risk factor for food allergy-related atopic dermatitis in infants and young children

“…In our study, an atopic background was proven in only 9% of children with hypogammaglobulinemia and in 15% of children with normal immunoglobulin production. These data may suggest a growing importance and high incidence of non-IgE-mediated food allergic disorders in the children studied, accounting for up to 40% of milk protein allergy in infants and young children [22,23] and which manifest as profuse enterocolitis syndrome with diarrhea, repetitive vomiting and failure to thrive or as benign allergic proctocolitis with bloody stools. However, in children with hypogammaglobulinemia, as to isolated or combined immunoglobulin deficiencies, low serum IgE may rather reflect a multiple immunoglobulin deficit and therefore, the role of the non-IgE mediated allergic pathway in this group of immunodeficient children must be particularly emphasized [24,25].…”

Profile of gastrointestinal diseases in a pediatric gastroenterology center in Colombia: 15 years of follow-up

“…Diversas instituciones en los Estados Unidos han estimado tasas de prevalencia del 3,5% a 4% (16). En un estudio realizado en Estados Unidos, se registró un aumento significativo entre el 2000 y el 2010, de 3,4 a 4,6 % (17).…”

Nutritional outcomes in infants with food allergy after cardiac surgery

“…During May 2016 and December 2016, patients who received cardiac surgery in heart center in Shanghai Children's Medical Center were eligible for this study. Forty infants between the ages of 4 and 12 months were identified, with diagnosed food allergy according to the current guidelines for food allergy and all cases were confirmed by at least one positive allergen‐specific IgE. Thirty‐nine CHD infants with no atopic disorders who were negative in all IgE tests were recruited during the same period as potential controls.…”