- Clinico-paraclinical features of the course of food4induced enterocolytic syndrome in young children
Clinico-paraclinical features of the course of food4induced enterocolytic syndrome in young children
PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.4(76):99-105; doi 10.15574/PP.2018.76.99
Haiduchik H. A.
SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv
Purpose — to study the clinical and paraclinical features of the course of food-induced enterocolic syndrome in young children.
Patients and methods. A comprehensive examination was performed on 24 children aged 2 months to 3 years with induced food proteins with enterocolitis syndrome, which included: general-clinical examination; determination of the levels of total IgE and specific IgE antibodies to food allergens by the ImmunoCAP method; staging of diagnostic patch tests; determination of the concentration of TNF-α in serum by the IFA method; instrumental research (colonoscopy with biopsy) with clear indications. The results of the received data were processed statistically.
Results. Induced food proteins enterocolitis syndrome had a chronic course. Characteristic symptoms were vomiting or diarrhea between feeding, diarrhea with admixture of mucus and blood, flatulence, intense colic and delayed physical development. The most common allergen was the protein of cow's milk, which is confirmed by the positive result of oral provocative test. The increase in the concentration of TNF-α in the blood serum of the examined patients was revealed, which indicates the activation of cell-mediated proinflammatory processes that trigger chronic allergic inflammation.
Conclusions. The diagnosis of enterocoly-induced food proteins is clinically established and requires differential diagnosis with a wide range of diseases due to the nonspecific clinical symptoms. In the case of an atypical course, the golden standard of diagnosis is the conduct of open oral provocative test, and the setting of patch tests is a useful additional method of diagnosis of hypersensitivity of the slowed-down type.
Key words: children of young age, food-induced enterocolitis syndrome, non-IgE-mediated allergy, oral provocative test.
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Article received: Aug 30, 2018. Accepted for publication: Nov 29, 2018.