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Allergic Diseases and Immune-Mediated Food Disorders in Pediatric Acute-Onset Neuropsychiatric Syndrome.
Pediatric Allergy, Immunology, and Pulmonology ( IF 0.9 ) Pub Date : 2018-10-05 , DOI: 10.1089/ped.2018.0888
Jaime S Rosa 1, 2 , Joseph D Hernandez 1, 2 , Janell A Sherr 1, 2 , Bridget M Smith 3, 4 , Kayla D Brown 2 , Bahare Farhadian 2 , Talia Mahony 2 , Sean A McGhee 1 , David B Lewis 1, 2 , Margo Thienemann 2 , Jennifer D Frankovich 1, 2
Affiliation  

Background: The prevalence and impact of allergic and immune-mediated food disorders in pediatric acute-onset neuropsychiatric syndrome (PANS) are mostly unknown. Objective: We sought to explore the prevalence of atopic dermatitis (AD), asthma, allergic rhinitis (AR), IgE-mediated food allergies (FAs), and other immune-mediated food disorders requiring food avoidance in patients with PANS. In addition, to further understand the extent of food restriction in this population, we investigated the empiric use of dietary measures to improve PANS symptoms. Methods: Pediatric patients in a PANS Clinic and Research Program were given surveys regarding their caregiver burdens, allergic and food-related medical history, and whether food elimination resulted in perception of improvement of PANS symptoms. A review of health records was conducted to confirm that all responses in the survey were concordant with documentation of each patient's medical chart. Results: Sixty-nine (ages 4-20 years) of 80 subjects who fulfilled PANS criteria completed the surveys. Thirteen (18.8%) had AD, 11 (15.9%) asthma, 33 (47.8%) AR, 11 (15.9%) FA, 1 (1.4%) eosinophilic gastrointestinal disorders, 1 (1.4%) food protein-induced enterocolitis syndrome, 3 (4.3%) milk protein-induced proctocolitis syndrome, and 3 (4.3%) celiac disease. Thirty subjects (43.5%) avoided foods due to PANS; elimination of gluten and dairy was most common and was associated with perceived improvement of PANS symptoms (by parents). This perceived improvement was not confirmed with objective data. Conclusions: The prevalence of allergic and immune-mediated food disorders in PANS is similar to the general population as reported in the literature, with the exception of AR that appears to be more prevalent in our PANS cohort. More research will be required to establish whether diet or allergies influence PANS symptoms.

中文翻译:

小儿急性发作神经精神病综合症的过敏性疾病和免疫介导的食物失调。

背景:过敏性和免疫介导的食物异常在儿童急性发作性神经精神病综合症(PANS)中的流行和影响尚不清楚。目的:我们寻求探讨PANS患者中特应性皮炎(AD),哮喘,变应性鼻炎(AR),IgE介导的食物过敏(FAs)以及其他需要避免食物的免疫介导的食物失调的患病率。此外,为了进一步了解该人群中食物限制的程度,我们调查了饮食手段改善PANS症状的经验性使用。方法:对PANS临床和研究计划中的小儿患者进行调查,调查对象包括照顾者的负担,过敏和与食物有关的病史,以及食物的清除是否导致对PANS症状改善的感知。对健康记录进行了审查,以确认调查中的所有答复均与每位患者病历的文件一致。结果:符合PANS标准的80位受试者中的69位(年龄4-20岁)完成了调查。十三(18.8%)患有AD,11(15.9%)哮喘,33(47.8%)AR,11(15.9%)FA,1(1.4%)嗜酸性胃肠道疾病,1(1.4%)食物蛋白诱导的小肠结肠炎综合征, 3例(4.3%)乳蛋白诱发的结肠炎综合征和3例(4.3%)乳糜泻。30名受试者(43.5%)避免因PANS食用食物;消除麸质和乳制品是最常见的方法,并且与感觉到的PANS症状改善(父母)有关。客观数据并未证实这种感知的改善。结论:正如文献中报道的那样,在PANS中,变态反应和免疫介导的食物失调的患病率与普通人群相似,但AR在我们的PANS队列中似乎更为普遍。需要进一步的研究来确定饮食或过敏是否会影响PANS症状。
更新日期:2019-11-01
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