Clinical Features and Clinical Course of Food Protein—Induced Allergic Proctocolitis: 10-Year Experience of a Tertiary Medical Center
Journal of Allergy and Clinical Immunology: In Practice, cilt.10, sa.6, ss.1608-1613, 2022 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 10 Sayı: 6
- Basım Tarihi: 2022
- Doi Numarası: 10.1016/j.jaip.2022.02.013
- Dergi Adı: Journal of Allergy and Clinical Immunology: In Practice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1608-1613
- Anahtar Kelimeler: Bloody-mucus stool, Diarrhea, Food protein-induced allergic proctocolitis, Infant, Tolerance
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Food protein–induced allergic proctocolitis (FPIAP) is a food allergy characterized by bloody stools in well-appearing breast-fed infants. Objective: To determine the clinical course of FPIAP and the factors affecting the development of tolerance. Methods: Over a 10-year period, patients with a diagnosis of FPIAP who were followed at the outpatient Allergy-Immunology clinic in a tertiary care children's hospital in Turkey were retrospectively analyzed. Results: The frequency of FPIAP was 0.18% among 64,549 patients. The median age of symptom onset was 2 months (interquartile range, 1.0-3.5 months), and the median age of tolerance development was 12 months (interquartile range, 8.0-17.21 months). The occurrence of symptoms in the neonatal period was associated with a history of premature birth (odds ratio, 3.75; 95% CI, 1.33-10.59; P = .031) and neonatal intensive care unit hospitalization (odds ratio, 4.72; 95% CI, 1.78-12.53; P = .002). Use of a cow's milk–based formula was associated with a higher risk of the onset of symptoms after 1 month (odds ratio, 2.69; 95% CI, 1.19-6.07; P = .016). The use of an amino acid–based formula and the presence of diarrhea at admission were associated with later development of tolerance (P = .023 and P < .001, respectively). An IgE-mediated reaction was observed during oral food challenge testing in 6% of the patients. Conclusions: The manifestations of FPIAP appeared earlier in premature infants and later in infants using formula. The use of amino acid–based formula and having had diarrhea were associated with delayed tolerance.