Background

Food protein–induced allergic proctocolitis (FPIAP) is a non–immunoglobulin E (IgE)-mediated food allergy, which presents with bloody mucoid stool in infants. Although IgE-mediated allergy and sensitizations to offending foods have been described in other non–IgE-mediated food allergies, it has not been investigated in FPIAP.

Objective

To investigate IgE-mediated allergy and sensitization to offending foods in FPIAP.

Methods

Patients (n = 204) were retrospectively recruited and grouped as FPIAP (n = 180; FPIAP with or without the symptoms of IgE-mediated food hypersensitivity to offending and nonoffending foods at initial consultation), FPIAP-IgE sensitization to offending foods (n = 17), and FPIAP-transition to IgE-mediated allergy to offending foods (n = 7). The study was performed in accordance with the protocol approved by the local ethical committee of the Hacettepe University.

Results

The median age of onset of symptoms and the development of tolerance was 2 months (interquartile range [IQR], 1.0-3.0) and 12 months (IQR, 10.0-14.0), respectively, and of the patients with skin prick test or serum specific IgE tests (n = 196), 38 (19.4%) had evidence of IgE sensitization to offending foods at the initial consultation or during follow-up; 17 (8.6%) had IgE sensitization, 7 (3.6%) indicated a transition to IgE-mediated allergy to FPIAP-induced foods. The median age of tolerance development of the FPIAP-transition group (19 months, IQR, 18.0-29.0) was significantly later than that of the FPIAP group (11 months, IQR, 10.0-14.0; P < .001) and the FPIAP-IgE sensitization group (11.0 months, IQR, 9.5-12.0; P < .001). Tolerance was observed within the study period in almost all the patients.

Conclusion

Children with FPIAP may have sensitization or develop IgE-mediated allergy over time to offending foods. In addition, IgE sensitization in FPIAP does not have an unfavorable effect on tolerance development; however, the transition to an IgE-mediated phenotype may delay tolerance for a brief time.

背景：食物蛋白诱发的过敏性结肠炎（FPIAP）是一种非免疫球蛋白E（IgE）介导的食物过敏，表现为婴儿血性粘液样大便。

目的：尽管在其他非IgE介导的食物过敏中也描述了IgE介导的对过敏性食物的过敏和敏化作用，但FPIAP尚未对此进行研究。因此，我们旨在研究IgE介导的对FPIAP中有害食品的过敏和敏感性。

方法：回顾性收集204例患者，将其分为FPIAP（n = 180； FPIAP +/- IgE介导的对初次就诊的不合格食品过敏的食物过敏症状），FPIAP-IgE对违规的食品过敏（ n = 17），以及FPIAP向IgE介导的对过敏性食物的过敏（n = 7）。

结果：接受SPT或血清sIgE检测的患者的中位症状发作年龄和耐受性发展分别为两个月（IQR; 1.0-3.0个月）和12个月（IQR; 10.0-14.0个月）。 （n = 196），有38名（19.4％）在初步咨询或随访期间有IgE对过敏性食物过敏的证据；17（8.6％）人对IgE致敏，7（3.6％）人向FPIAP诱导的食物转变为IgE介导的过敏。FPIAP过渡组的耐受性发展中位年龄（19个月，IQR； 18.0-29.0）显着晚于FPIAP组（11个月，IQR； 10.0-14.0个月，p <0.001）和FPIAP-IgE敏化组（11.0个月，IQR； 9.5-12.0个月，p <0.001）。在研究期内几乎所有患者均观察到耐受性。

结论

随着时间的流逝，患有FPIAP的儿童可能会对过敏性食物过敏或发展IgE介导的过敏。FPIAP中的IgE致敏化对耐受性的发展没有不利影响，但是，向IgE介导的表型的转变可能会在短时间内延迟耐受性。