Children food allergy

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Children food allergy Business claims

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Allergic gastroenteritis, is due to a food or food additives caused by IgE-mediated and non-IgE-mediated immune response, which led to the digestive system or Systemic allergy.

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Food allergy, also known as allergic reaction of digestive system or allergic gastroenteritis, food allergy, is caused by certain foods or food additives, IgE-mediated and non-IgE-mediated immune responses, leading to digestive or systemic allergy.

Etiology / Pediatric Food Allergy Editor

(A) causes 1. Food-induced allergic pathways induce children allergies in five ways: gastrointestinal ingestion, respiratory inhalation, skin contact or injection, through the human milk and placenta into. 2. Food allergens Food allergens refer to the food antigen molecules that cause an immune response. Almost all food allergens are proteins, most of the water-soluble glycoprotein, molecular weight of 100,000 to 600,000. Each food protein may contain several different allergens. Food allergens have the following characteristics: (1) any food can induce allergic reactions: but children common food allergens for milk, eggs, soybeans, including milk and eggs are the most common strong allergens in children. Sensitization of food due to the different regional eating habits vary. Peanuts are both children and adults are common allergens, seafood is not the main allergen in children, nut-induced allergies in children is relatively rare. Although any food can be sensitized, about 90% of allergic reactions are caused by a small number of foods, such as milk, eggs, peanuts and wheat. (2) only part of the food with allergenicity: milk and eggs, for example, at least five kinds of milk with allergenicity, which casein, B-lactoglobulin (-lactoglobulin, -LC ) The strongest allergenicity. Egg yolk with a very small allergen, egg white ovalbumin and egg mucin in the egg is the most common allergen. (3) variability of food allergen: heating can make the allergenicity of most foods reduced. Increased acidity of the stomach and the presence of digestive enzymes may reduce food allergenicity. (4) there is cross-reactivity between food: different proteins may have a common antigenic determinants, so that allergens with cross-reactivity. Such as at least 50% of milk allergy are also allergic to goat milk. Those who are allergic to eggs may be allergic to eggs from other birds. Cross-reactions do not exist between milk and beef, nor between eggs and chicken. The cross-reactivity of the plants was more pronounced than that of the animals. Such as those who are allergic to soy may also be other members of leguminous plants such as lentils, alfalfa and other allergies. Patients allergic to pollen also respond to fruits and vegetables, such as those allergic to birch pollen, but also to apples, hazelnuts, peaches, apricots, cherries, carrots and other reactions. Those who are allergic to Artemisia also respond to umbellate ketones such as celery, fennel and carrots. (5) of the food intermediate metabolites allergies: very rare, more patients in the 2 ~ 3h after eating symptoms. 3. Genetic factors Food allergies and genetic related. Parents have a history of food allergies, their children's prevalence rate of 30%, both parents are suffering from the disease, the child prevalence rate of up to 60%. 4. Anatomical factors The nonspecific and specific mucosal barrier system of the human gastrointestinal tract can limit the intact protein antigen invasion, and enter the intestinal food antigen and secretory IgA (SIgA) binding, the formation of antigen-antibody complexes, limiting the intestinal The absorption of food antigens, thus directly or indirectly reduce the food protein immune response. Pediatric mucosal tenderness, high vascular permeability, poor function of the digestive tract barrier, a variety of food allergens easily through the intestinal mucosa into the blood, causing allergic reactions. Infants with less than 3 months of age had lower levels of IgA, and the number of plasma cells producing SIgA in the mucosal lamina propria was less. When the digestion and absorption process and mucosal immune abnormalities are caused by a variety of food allergens easily through the intestinal mucosa into the blood and the occurrence of allergic gastroenteritis. 5. Other factors of gastrointestinal inflammation is one of the causes of increased incidence of intestinal allergies. This is due to gastrointestinal inflammation caused by gastrointestinal mucosal injury, increased gastrointestinal mucosal permeability, so that too much food antigen is absorbed, and allergic reactions. (B) the pathogenesis of sensitizing antigen activation of intestinal membrane of the IgE plasma cells, resulting in a large number of IgE antibodies, and mast cells in combination, fixed on the surface of these cells. When the allergens in food again into the body, and the surface of the gastric mucosal mast cell IgE combined to mast cell activation, degranulation, the release of a series of inflammatory mediators involved in allergic reactions, increased vascular permeability, causing Type allergy. Some antigenic substances can also selectively combine with plasma cells IgG, IgM, IgA or T cells to form immune complexes, causing local or (and) systemic type or type allergy. The age, food digestion process, gastrointestinal permeability, the structure of food antigens, genetic factors can affect the occurrence of food allergic reactions. Food allergies in the first few years after birth the most common, most children to 2 to 3 years of age on the food tolerance, the symptoms disappeared. IgE mediators may last longer. The severity of the onset was not associated with subsequent disappearance of clinical symptoms. However, due to avoid food allergen is not complete, especially teenage children, resulting in the persistence of its sensitivity.

Symptoms / Pediatric Food Allergy Editor

The severity of clinical manifestations, and food allergenicity of the strength and host susceptibility. 1.IgE-mediated food allergy clinical symptoms appear faster, can be a few minutes after eating to 1 ~ 2h. Sometimes very trace can cause very serious allergic symptoms. In terms of the order of symptoms, the earliest appearance is often skin, mucosal symptoms. Respiratory symptoms such as asthma late or do not appear, but often accompanied by severe respiratory symptoms, food-induced asthma in infants more common, in addition to inhalation caused by those who are generally combined with other allergic symptoms. Although older children and adults can induce a variety of food allergy symptoms, including shock, but induced asthma is rare. Food generally does not cause allergic rhinitis, allergic rhinitis as the only symptom of food allergy is very rare. Allergic eosinophilic gastrointestinal disease: characterized by gastric or small intestinal wall with EOS infiltration, often increased peripheral blood EOS. EOS infiltration involving the stomach or small intestine mucosa, muscle and / or serosa. Patients often show nausea and vomiting after meals, abdominal pain, intermittent diarrhea, infant growth retardation. Myometrial invasion and thickening of the stomach and small intestine resulting in clinical signs of obstruction may occur. Subependymal infiltration of the general performance of EOS ascites. Pathogenesis of this disease is unknown. Some of these patients after eating a food symptoms increased, involving type I allergy, patients with duodenal fluid and serum IgE increased, with more atopic disease, a variety of food and inhalation skin prick test positive . Can be secondary to iron deficiency anemia and hypoalbuminemia. The disease often involving 6 to 18 months of the baby. Diagnosis Based on gastrointestinal biopsy, the characteristic increase in EOS. Mucosal patients often have atopic symptoms, serum total IgE increased, a variety of allergen skin test and RAST, was positive, increased peripheral blood EOS, anemia and so on. Exclude allergy food to up to 12 weeks before the symptoms will disappear, intestinal tissue will return to normal. Infantile colic: the performance of the baby paroxysmal irritability, extreme pain crying, legs curled up, abdominal distension, exhaust more generally in the 2 to 4 weeks after birth disease, to 3 to 4 months recovery. The diagnosis relies on the exclusion test. Oral allergy syndrome (OAS): the patient in the eating of one or several fruits or vegetables a few minutes later, the oropharynx such as the lips, tongue, palate and throat itching and swelling, a small number of patients suffering from oral mucosal hypersensitivity syndrome Children with systemic allergic symptoms. Occurring in hay fever patients or hints may occur after hay fever. This is a cross-reactivity between pollen and fruits or vegetables. 2. Non-IgE (ie, IgM, IgG, or several antibodies combined) -mediated food allergy II, III, and IV immunopathology may be involved, but direct evidence is scarce, and it is believed that some food adverse reactions involve non-IgE Immune mechanism. Type II and type II, such as milk-induced involving and type, such as herpes-like dermatitis, gluten-induced enteropathy, milk-induced intestinal bleeding, food-induced enterocolitis syndrome, food-induced malabsorption syndrome Wait. Can also cause allergic pneumonia, bronchial asthma, atopic dermatitis, contact dermatitis, allergic purpura and so on. Diagnosis of food allergy, first according to the detailed history, skin test or RAST results to determine. If suspected IgE-mediated, should be excluded from the food, if necessary, to do blind attack, but the history of severe allergic reactions or a clear diagnosis of those who do not do. Suspected non-IgE-mediated food-induced gastrointestinal disease, the diagnosis of pre-attack and post-attack need to be biopsy, unconditional food exclusion should be done and the attack test. According to history and (or) skin test suspected IgE-mediated disease or food-induced enterocolitis, suspicious food should be excluded for 1 to 2 weeks. Other Gastrointestinal Allergies Eliminate suspicious food for up to 12 weeks. If the symptoms do not improve, it is unlikely that the food allergy. The diagnosis of Type I food allergy can not be made solely on the basis of a skin test or RAST. Many patients are thus misdiagnosed as a food-induced food allergy, and avoid the food they should not fast. Therefore, the history of blind attack and food is very important to the diagnosis of the cause.

Treatment / Pediatric Food Allergy Editor

(A) Treatment 1. Avoid allergens Once it is determined that allergens should be strictly avoided re-eating, this is the most effective means of prevention. But "avoid" should be targeted, such as egg most vulnerable part of the egg white, edible part of the egg yolk. Generally 6 to 12 months after the children of most of the sensitivity of food antigens disappear. In addition, cooking or heating causes the loss of allergenicity of most food antigens. 2. Drugs generally do not advocate long-term ketotifen, corticosteroid prevention. The effect of oral cromoglic acid is uncertain. Do not advocate to food for IT. But OAS can be used to sensitize pollen for IT, 1 year after the majority of patients with pollen and plant food sensitivity decreased. But in food-induced symptoms, should be symptomatic treatment. (B) the prognosis of the general prognosis is good, and more with age and gradually ease. But improper handling, disease migration development, often caused by malnutrition, growth disorders.

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