Tolerability and safety of a new elimination diet for pediatric eosinophilic gastritis and duodenitis

被引:4
作者
Nagashima, Saori [1 ]
Yamamoto, Mayu [1 ]
Inuzuka, Yusuke [2 ]
Irahara, Makoto [2 ]
Miyaji, Yumiko [2 ]
Tadaki, Hiromi [3 ]
Ito, Shuichi [4 ]
Masuda, Shizuka [5 ]
Ito, Yoshiyuki [5 ]
Saito, Yuri [5 ]
Kobayashi, Saeko [5 ]
Morita, Hideaki [6 ]
Yoshioka, Takako [7 ]
Shimizu, Hirotaka [8 ]
Arai, Katsuhiro [2 ,8 ]
Ohya, Yukihiro [2 ]
Saito, Hirohisa [6 ]
Matsumoto, Kenji [6 ]
Nomura, Ichiro [1 ,2 ]
机构
[1] Natl Res Inst Child Hlth & Dev, Div Eosinophil Gastrointestinal Disorders, 2-10-1 Okura,Setagaya Ku, Tokyo 1578535, Japan
[2] Natl Ctr Child Hlth & Dev, Allergy Ctr, Tokyo, Japan
[3] Natl Hosp Org Yokohama Med Ctr, Dept Pediat, Yokohama, Kanagawa, Japan
[4] Yokohama City Univ, Grad Sch Med, Dept Pediat, Yokohama, Kanagawa, Japan
[5] Natl Ctr Child Hlth & Dev, Dept Nutr, Tokyo, Japan
[6] Natl Res Inst Child Hlth & Dev, Dept Allergy & Clin Immunol, 2-10-1 Okura,Setagaya Ku, Tokyo 1578535, Japan
[7] Natl Ctr Child Hlth & Dev, Dept Pathol, Tokyo, Japan
[8] Natl Ctr Child Hlth & Dev, Div Gastroenterol, Tokyo, Japan
关键词
Eosinophilic duodenitis (EoD); Eosinophilic gastrointestinal disorders (EGID; EGIDs); Eosinophilic gastritis (EoG); Elimination diet (ED); Non-IgE-mediated gastrointestinal food allergy; ELEMENTAL DIET; GASTROENTERITIS; ESOPHAGITIS; CHILDREN; DIAGNOSIS; REMISSION; EFFICACY; OUTCOMES; THERAPY;
D O I
10.1016/j.alit.2022.11.001
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs) are chronic in-flammatory disorders with massive infiltration of eosinophils into the gastrointestinal tract. Food elimination diets are potentially effective treatments. But the existing dietary therapies have various weak points. We developed a new regimen to compensate for the shortcomings of the elemental diet and 6-food elimination diet. The new regimen consists of an amino-acid-based formula, potatoes, vegetables, fruits and restricted seasonings. We named it the "Rainbow Elimination Diet (ED)." The aims of this study were to evaluate the tolerability and safety of this diet.Methods: A retrospective medical record examination was conducted at the National Center for Child Health and Development covering the period from January 2010 through December 2018. The medical records of patients (age 2-17 y) with histologically diagnosed non-EoE EGIDs were reviewed. The tolerability, nutritional intake, symptoms, and blood test findings were evaluated.Results: Nineteen patients were offered several kinds of food-elimination diets. Seven patients (eosin-ophilic gastritis: 5; gastroenteritis: 1; duodenitis: 1) were treated with Rainbow ED. Six patients were compliant with this diet. The median duration of the diet induction phase was 15 days (range 14-30). All 5 patients who had had symptoms just before the induction phase became symptom-free. The body weight decreased in 5 patients (median-0.6 kg), probably because the serum protein increased, resulting in reduced edema. All 5 patients with hypoproteinemia had elevated serum albumin (median 2.9-3.5 g/dL). The ingested nutritional elements were calculated, and most of them were sufficient, except for fat and selenium.Conclusions: The Rainbow ED was well-tolerated and safe for pediatric non-EoE EGIDs.(c) 2022 Japanese Society of Allergology. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:306 / 315
页数:10
相关论文
共 28 条
  • [1] Histologic eosinophilic gastritis is a systemic disorder associated with blood and extragastric eosinophilia, TH2 immunity, and a unique gastric transcriptome
    Caldwell, Julie M.
    Collins, Margaret H.
    Stucke, Emily M.
    Putnam, Philip E.
    Franciosi, James P.
    Kushner, Jonathan P.
    Abonia, J. Pablo
    Rothenberg, Marc E.
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2014, 134 (05) : 1114 - 1124
  • [2] Histopathologic Features of Eosinophilic Esophagitis and Eosinophilic Gastrointestinal Diseases
    Collins, Margaret H.
    [J]. GASTROENTEROLOGY CLINICS OF NORTH AMERICA, 2014, 43 (02) : 257 - +
  • [3] The Impact of Dietary Therapy on Clinical and Biologic Parameters of Pediatric Patients with Eosinophilic Esophagitis
    Colson, Diana
    Kalach, Nicolas
    Soulaines, Pascale
    Vannerom, Yves
    Campeotto, Florence
    Talbotec, Cecile
    Chatenoud, Lucienne
    Hankard, Regis
    Dupont, Christophe
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2014, 2 (05) : 587 - 593
  • [4] International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature
    Dellon, Evan S.
    Gonsalves, Nirmala
    Abonia, J. Pablo
    Alexander, Jeffrey A.
    Arva, Nicoleta C.
    Atkins, Dan
    Attwood, Stephen E.
    Auth, Marcus K. H.
    Bailey, Dominique D.
    Biederman, Luc
    Blanchard, Carine
    Bonis, Peter A.
    Bose, Paroma
    Bredenoord, Albert J.
    Chang, Joy W.
    Chehade, Mirna
    Collins, Margaret H.
    Di Lorenzo, Carlo
    Dias, Jorge Amil
    Dohil, Ranjan
    Dupont, Christophe
    Falk, Gary W.
    Ferreira, Cristina T.
    Fox, Adam T.
    Genta, Robert M.
    Greuter, Thomas
    Gupta, Sandeep K.
    Hirano, Ikuo
    Hiremath, Girish S.
    Horsley-Silva, Jennifer L.
    Ishihara, Shunji
    Ishimura, Norihisa
    Jensen, Elizabeth T.
    Gutierrez-Junquera, Carolina
    Katzka, David A.
    Khoury, Paneez
    Kinoshita, Yoshikazu
    Kliewer, Kara L.
    Koletzko, Sibylle
    Leung, John
    Liacouras, Chris A.
    Lucendo, Alfredo J.
    Martin, Lisa J.
    McGowan, Emily C.
    Menard-Katcher, Calies
    Metz, David C.
    Miller, Talya L.
    Moawad, Fouad J.
    Muir, Amanda B.
    Mukkada, Vincent A.
    [J]. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2022, 20 (11) : 2474 - +
  • [5] Effect of anti-IgE therapy on food allergen specific T cell responses in eosinophil associated gastrointestinal disorders
    Foster B.
    Foroughi S.
    Yin Y.
    Prussin C.
    [J]. Clinical and Molecular Allergy, 9 (1)
  • [6] Gonsalves N, 2009, GASTROENTEROL S, V136, pA
  • [7] Kabuki Tomoyuki, 2007, Allergol Int, V56, P473, DOI 10.2332/allergolint.C-06-48
  • [8] Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis
    Kagalwalla, Amir F.
    Sentongo, Timothy A.
    Ritz, Sally
    Hess, Therese
    Nelson, Suzanne P.
    Emerick, Karan M.
    Melin-Aldana, Hector
    Li, B. U. K.
    [J]. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2006, 4 (09) : 1097 - 1102
  • [9] Efficacy of a Short-term Six-food Elimination Diet and Reintroduction Therapy in Pediatric Eosinophilic Gastroenteritis
    Kakiuchi, Toshihiko
    Nakayama, Aiko
    Abe, Jun
    Matsuo, Muneaki
    [J]. INTERNAL MEDICINE, 2020, 59 (11) : 1379 - 1385
  • [10] Modified oral enteric-coated budesonide regimens to treat pediatric eosinophilic gastroenteritis, a single center experience
    Kennedy, Katie
    Muir, Amanda B.
    Grossman, Andrew
    Brown-Whitehorn, Terri
    Cianferoni, Antonella
    Spergel, Jonathan M.
    Furuta, Glenn T.
    Wilkins, Benjamin J.
    Shuker, Michele
    Ruffner, Melanie A.
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2019, 7 (06) : 2059 - 2061