scholarly journals Food Allergy in Children with Inherited Epidermolysis Bullosa. The Results of the Observational Study

2018 ◽  
Vol 73 (1) ◽  
pp. 49-58 ◽  
Author(s):  
S. G. Makarova ◽  
L. S. Namazova-Baranova ◽  
N. N. Murashkin ◽  
E. A. Vishneva ◽  
R. V. Epishev ◽  
...  

Background: Inherited epidermolysis bullosa (EB) refers to a group of rare inherited disorders characterized by severe damage of skin and in most patients — the gastrointestinal mucosa, what leads to a violation of skin and mucosal barrier properties in relation to allergens. However, the issues of food sensitization and food allergy in this category of patients have not been studied, and the study of this problem is important.Aim: To evaluate the clinical manifestations of food allergy (FA) and IgE-response to food proteins in children with EB.Methods: 82 patients with EB aged from 2 months to 16 years were entered this open non-randomized observational prospective study, including 20 patients with simple form of EB and 62 patients with dystrophic form of EB. We analyzed allergic history and clinical manifestations of the FA in all the patients. Every patient in this study underwent of determination of the concentration of total serum IgE and specific serum IgE to the most important food allergens, as well as to mixtures of household allergens in some cases (UniCAP System, Phadia AB). Results: Skin lesion in patients with EB masks allergic skin manifestations, causing a hypodiagnosis of the FA in this category of patients, which in turn leads to erroneous organization of nutritional support. FA (clinical manifestations) was identified in 20.7% of children with EB (in 10% of cases with simple form of EB and in 24.2% — in patients with dystrophic form of EB). Products containing cow’s milk protein, cereals, and eggs were identified as etiologic factors of FA in most cases. In the group of children with comorbidity FA and EB high and very high levels of total IgE (1000 kUA / l) were detected most frequently. The main cause-significant allergens are cow’s milk proteins, cereals, eggs. Conclusions: Comorbidity with FA is high in patients with dystrophic form of EB. The main cause-significant allergens are cow’s milk proteins, cereals, eggs.

2017 ◽  
Vol 81 (1) ◽  
pp. 99-103
Author(s):  
V.D. Barzylovych ◽  
◽  
T.V. Pochinok ◽  
A.D. Barzylovych ◽  
◽  
...  

2019 ◽  
Vol 16 (2) ◽  
pp. 38-44
Author(s):  
S Yu Petrova ◽  
S V Khlgatian ◽  
V M Berzhets ◽  
L A Pishchulina ◽  
A V Vasilyeva

Identification of offending allergens in patients with food allergy is a very important part of an allergist’s activity. Objective. To study the structure оf sensitization to food allergens among children in Moscow and Moscow region and to determine the significance of sensitization to milk proteins . Methods. The level and class of specific IgE in blood serum of children with IgEmediated allergic diseases were examined with RIDA AllergyScreen method. Serum of children with high level of specific IgE to milk allergenic proteins was studied. The level and ratio of specific IgE to individual milk allergens were revealed. Results. The structure of sensitization to food allergens was determined. It was revealed that cow’s milk allergens are the leading triggers of food allergy, especially in early childhood in Moscow and the Moscow region. The features of sensitization to cow’s milk proteins among children were analyzed. Conclusions. According to the study, about half of children with IgEmediated food allergies in Moscow and the Moscow region have sensitization to cow’s milk proteins. The leading role in the frequency of sensitization belongs to whey proteins of milk. Among them sensitization to а-lactalbumin was detected more often. The questions about the selection of hypoallergenic milk formulas for feeding of children with allergy to cow’s milk proteins were discussed.


Author(s):  
Albina Galimova ◽  
Svetlana Vyazankina ◽  
Svetlana Makarova ◽  
Oksana Ereshko

Food allergy is a potentially life-threatening condition in which there are no approved pathogenetic treatments other than elimination of the causal allergen and relief of acute allergic conditions. IgE- mediated form of food allergy remains a serious and growing problem worldwide. Its prevalence is steadily increasing, and is a severe psychosocial and economic burden for patients and their families. Cow's milk and products based on it are important components of a child's diet, which are introduced into the diet of children of the first year of life, but can cause allergic reactions. The traditional management of children with cow's milk allergy consists in prescribing an elimination dairy-free diet and a significant part of patients form tolerance to milk proteins by the age of 5 years. However, with persistent forms of allergy to cows milk proteins, the question is raised about the need for "active" tactics of patient management in order to form tolerance. Oral immunotherapy is a promising approach to the treatment of food allergies based on a gradual increase in the allergen taken, by analogy with standardized immunotherapy for respiratory allergens, until a maintenance dose is reached. Each stage of oral immunotherapy should be considered as a personalized therapy. This review contains an analysis of available studies on the effectiveness of oral immunotherapy in the treatment of allergy to cow's milk proteins.


1970 ◽  
Vol 5 (4) ◽  
pp. 51-60
Author(s):  
José Henrique Pereira Pinto ◽  
Renan Lemos de Toledo ◽  
William do Prado Franquelo

RESUMOIntrodução: Alergia à Proteína do Leite de Vaca (APLV) é uma doença inflamatória secundária à reação imunológica contra uma ou mais proteínas do leite de vaca (LV) que afeta principalmente a faixa pediátrica. A real prevalência é discutida em muitos estudos. As manifestações clínicas dependem do tipo da resposta imunológica, ser IgE mediada ou não. Os sintomas se iniciam por volta dos 06 meses de vida e na maioria dos casos, esse processo alérgico regride, com o paciente desenvolvendo tolerância até a adolescência. Casuística: Relata-se um caso de um paciente do sexo masculino, apresentando desde os 6 meses de idade de anafilaxia e broncoespasmo. Nesta época foi levado em hospitais e ambulatórios sendo diagnosticado e tratado como asma apenas, porém sem sucesso. Aos 18 anos, em consulta com especialista foi diagnosticado com APLV, apesar da dieta de exclusão, apresentou diversas reações anafiláticas, devido a ingestão acidental do alérgeno. Discussão: O paciente iniciou os primeiros sintomas quando houve contato com LV e apresentou teste laboratorial com valores compatíveis a patologia. Segundo a literatura a prevalência de APLV cai para menos de 1% aos 6 anos de vida e está persistência pode estar associada a múltiplos fatores, no caso relatado, o paciente não apresentou tolerância até o presente momento. Conclusão: APLV é uma doença usualmente de criança em que, se estas não adquirirem tolerância, complicações podem perdurar indefinidamente. O Diagnóstico precoce e o manejo adequado desta condição, revela grande importância na qualidade de vida e na prevenção de anafilaxia.Palavras chave: Alergia, Proteína do leite de vaca, Anafilaxia. ABSTRACT Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease secondary to immune response against one or more cow's milk proteins (LV) which primarily affects pediatric patients. The current prevalence is discussed in many studies. The clinical manifestations depend on the type of immune response, being IgE mediated or not. Symptoms start at about 06 months of life and in most cases, the allergic process subsides, and the patient develops tolerance through adolescence. Case Report: We report the case of a male patient, who was presenting, since his 06 months of age, anaphylaxis and bronchospasm. At that time he was taken into hospitals and clinics being diagnosed and treated as asthma, but without success. At 18, in consultation with expert was diagnosed with CMPA, and despite the exclusion diet, presented several anaphylactic reactions due to accidental ingestion of the allergen. Discussion: The patient began the first symptoms when there was contact with LV and presented laboratory test values compatible with the pathology. According to the literature the prevalence of CMPA drops to less than 1% to 6 years of life and this persistence can be associated with multiple factors, in our case, the patient did not develop tolerance to date. Conclusion: CMPA is usually a child disease but ,if they do not acquire tolerance, complications can last indefinitely. Early diagnosis and appropriate management of this condition, reveals a great deal on quality of life and prevention of anaphylaxis. Keywords: Allergy, Cow’s milk protein, Anaphylaxis. 


PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 299-300
Author(s):  
LASSE LOTHE ◽  
TOR LINDBERG ◽  
IRÉNE JAKOBSSON

In Reply.— We fully agree with LeBlanc that there was no significant improvement when infants with colic were given a soy protein-based formula. As pointed out in the "Discussion," as many as 53% of the infants showed an adverse reaction to soy (corresponding figure for cow's milk formula was 71%). We also emphasized that these figures must be interpreted with caution. In fact, soy protein-based formula was a bad choice as placebo. A placebo substance should be a substance of no importance as an allergen in infancy and soy protein has been shown to be as antigenic as cow's milk proteins (Eastham EJ, et al: J Pediatr 1978;93:561).


Author(s):  
Гайдучик Г. А.

The purpose of the work was to evaluate the effectiveness of the elimination diet in infants with gastrointestinal manifestations of food allergy.Patients and methods. 84 children aged 2 months to 1 year were examined with gastrointestinal food allergy to cow's milk proteins. All children were prescribed an elimination diet with the exclusion of cow's milk proteins. An assessment was made of the regression of gastrointestinal symptoms on day 3, 7 and 14 of diet therapy and the determination of the concentration of eosinophilic cationic protein in serum. The general-clinical, immunological, allergological and statistical methods of research were used.Results. The purpose of the elimination diet with the exclusion of cow's milk proteins for nursing mothers and the use of mixtures with extensive hydrolysis of protein in the case of artificial feeding leads to a complete regression of gastrointestinal and skin symptoms in all examined children on the 14th day of diet therapy, which is further confirmed by the normalization of the concentration of eosinophilic cationic serum protein in diet therapy. Conclusions. Elimination of cow's milk proteins in infants with gastrointestinal food allergy results in complete regression of gastrointestinal and skin symptoms on day 14 of diet therapy, and determination of the concentration of eosinophilic cationic protein in serum can be used as an additional criterion for the effectiveness of diet therapy.


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