Lymphonodular Hyperplasia As a Sign of Food Allergy in Children

Kokkonen, Jorma; Karttunen, Tuomo J.; Niinimäki, Aila

doi:10.1097/00005176-199907000-00015

Cited by 48 publications

(42 citation statements)

References 16 publications

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“…1,2 Furthermore, it can occur in school-age children, 3,5,12 who frequently exhibited LNH of the colon, which is now considered a possible marker of FH in children. [3][4][5][6][7][8] On this basis, we performed a study in adults to search for a possible relation between FH, proctitis, and LNH.…”

Section: Discussionmentioning

confidence: 99%

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Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

Carroccio

Iacono

Prima

et al. 2009

Clinical Gastroenterology and Hepatology

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Section: Discussionmentioning

confidence: 99%

“…3 Others described LNH as an endoscopic marker of cow's milk allergy in children. [4][5][6][7][8] This prospective study showed that rectal bleeding and intestinal LNH can be caused by FH in adult patients.…”

mentioning

confidence: 84%

Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

Carroccio

Iacono

Prima

et al. 2009

Clinical Gastroenterology and Hepatology

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“…17,18 The endoscopic and immunohistochemical findings of duodenal biopsies confirm our previous findings concerning the mucosal state in the duodenum of patients with CMSE. We found LNH in one third of the CMSE subjects and a significant elevation in the densities of intraepithelial CD3, ab-and gd-positive T cells in the duodenum, 12,23 indicating that CMSE should be included in the differential diagnostic consideration when increase in IELs, a hallmark of CD, 18 is seen in biopsies, or LNH is seen at endoscopy. In CMSE, the concentrations of GrA and GrB showed most discriminative values in comparison with control subjects.…”

Section: Discussionmentioning

confidence: 75%

“…11 In CMSE the distribution of mucosal changes varies, and in many cases, in addition to the abnormalities in the proximal small intestine, ileal and colon mucosa may also show an increase in IELs. 23 We thus speculate that, like the extent of villous changes in CD associating with serum GrA levels, the serum concentration of GrB in CMSE may depend on the extent of mucosal lesions; higher values possibly associate with a more extensive intestinal immune response. However, more studies are necessary to confirm this idea.…”

Section: Discussionmentioning

confidence: 79%

Serum granzymes and CD30 are increased in children's milk protein sensitive enteropathy and celiac disease

Augustin¹,

Kokkonen

Karttunen³

et al. 2005

Journal of Allergy and Clinical Immunology

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“…Food allergy with typical reflux symptoms provides specific endoscopic and histological pictures of mucosa of upper gastrointestinal tract [14,16,25,26]. This is still the object of numerous studies on the youngest children with food hypersensitivity and GER, whereas in older children with persistent allergy [1,13,14,16,22,25,27,28].…”

Section: Introductionmentioning

confidence: 99%

Histological evaluation of esophageal mucosa in children with acid gastroesophageal reflux.

Semeniuk

Kaczmarski²,

Uścinowicz³

et al. 2009

Folia Histochem Cytobiol.

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AIM: histological evaluation of esophageal mucosa in children, with regard to the duration of primary acid gastroesophageal reflux (GER) and acid GER secondary to cow's milk allergy and/or other food allergy (CMA/FA) (prospective study). MATERIAL AND METHODS: 264 children of both sexes suspected of GER were enrolled in the study. The age of examined children was 1.5-102 months, mean age 20.78±17.23 months. Pathological acid GER was confirmed with pH-monitoring in 138 children (52.3%). Taking into consideration complex differential diagnosis, including oral food challenge test with potentially noxious nutrient (open or blind study), children were assigned into study groups 1 and 2 (primary and secondary GER). Group 1: 76 patients (28.8%) aged 4-102 months (x=25.2±27.28 months) with primary GER. Group 2: 62 patients (23.5%) aged 4-74 months (x=21.53±17.79 months) with GER secondary to CMA/FA. Children with GERD underwent preliminary and control (after 1 year and 2 years of GERD diagnosis) endoscopic examination of the upper gastroinestinal tract. RESULTS: Intensity of esophagitis was assessed initially in 25 children from group 1 (32.9%), in 29 children from group 2 (46.8%), and in 9 children from group 3 -reference group (28.1%). Histological evaluation revealed infiltration of inflammatory cells, mainly neutrophils and intraepithelial lymphocytes, and also eosinophils in 10 children (13.2%) with primary GER. Infiltration of eosinophils and lymphocytes was found in 5 children (8.1%) with secondary GER. In 8 children (25.0%) with food allergy there were only lymphocytes. Infiltration of neutrophils and lymphocytes and basal zone hyperplasia or infiltration of eosinophils and lymphocytes with elongation of lamina propria papillae was found in 10 children (13.1%) with primary GER and in 20 children (32.2%) with secondary GER. Differentiation of particular types of inflammatory cells in mucosal infiltration characterized histological picture in the following way: neutrophils in 21 children (27.6%) with primary GER, eosinophils in 22 children (35.5%) with secondary GER, lymphocytes in 15 children (19.7%) in children with primary GER and in 15 children (24.2%) with secondary GER. Histological examination of esophageal mucosa after 1 and 2 years of clinical observation and periodical conservative treatment in children with primary and secondary GER revealed significant alleviation of inflammatory abnormalities (with regard to the type of abnormalities and the number of particular types of inflammatory cells). CONCLUSIONS: The value of histological findings obtained in own studies comprises the role of food allergy in pathogenesis of GER and is related to GER's contribution, both direct (primary reflux) and indirect (secondary reflux), to triggering off morphological results and clinical outcomes of esophagitis.

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Lymphonodular Hyperplasia As a Sign of Food Allergy in Children

Abstract: Preliminary observations showed that lymphonodular hyperplasia of the duodenum or the colon is related to the gastrointestinal type of food allergy to basic foodstuffs. Further research is needed to define this finding as a separate entity.

Cited by 48 publications

References 16 publications

Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

Serum granzymes and CD30 are increased in children's milk protein sensitive enteropathy and celiac disease

Histological evaluation of esophageal mucosa in children with acid gastroesophageal reflux.

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