Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper

被引:109
作者
Meyer, Rosan [1 ]
Lozinsky, Adriana Chebar [2 ]
Fleischer, David M. [3 ]
Vieira, Mario C. [4 ]
Du Toit, George [5 ,6 ]
Vandenplas, Yvan [7 ]
Dupont, Christophe [8 ]
Knibb, Rebecca [9 ]
Uysal, Pimar [10 ]
Cavkaytar, Ozlem [11 ]
Nowak-Wegrzyn, Anna [12 ]
Shah, Neil [13 ]
Venter, Carina [3 ]
机构
[1] Imperial Coll London, Dept Paediat, London, England
[2] Murdoch Childrens Res Inst, Dept Allergy & Immune Disorders, Melbourne, Vic, Australia
[3] Univ Colorado, Childrens Hosp Colorado, Denver Sch Med, Aurora, CO USA
[4] Pontificia Univ Catolica Parana, Hosp Pequeno Principe, Ctr Pediat Gastroenterol, Dept Paediat, Curitiba, Parana, Brazil
[5] Kings Coll London, Dept Pediat Allergy, Div Asthma Allergy & Lung Biol, London, England
[6] Guys & St Thomas Natl Hlth Serv Fdn Trust, London, England
[7] Vrije Univ Brussel, UZ Brussel, KidZ Hlth Castle, Brussels, Belgium
[8] Necker Univ, Dept Paediat Gastroenterol, Children Hosp, Paris, France
[9] Aston Univ, Dept Psychol, Birmingham, W Midlands, England
[10] Adnan Menderes Univ, Dept Allergy & Clin Immunol, Aydin, Turkey
[11] Istanbul Medeniyet Univ, Gortepe Training & Res Hosp, Med Fac, Dept Pediat Allergy & Immunol, Istanbul, Turkey
[12] Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, New York, NY 10029 USA
[13] Great Ormond St Hosp London, Dept Gastroenterol, London, England
基金
美国国家卫生研究院;
关键词
breastfed children; diagnosis of non-IgE-mediated allergy; food allergy; maternal elimination; non-IgE-mediated allergy; PROTEIN-INDUCED ENTEROCOLITIS; COWS MILK ALLERGY; HEALTH-RELATED QUALITY; ATOPY PATCH TEST; GASTROESOPHAGEAL-REFLUX; EOSINOPHILIC ESOPHAGITIS; FOOD ALLERGY; LOSING ENTEROPATHY; OF-LIFE; MEDIATED REACTIONS;
D O I
10.1111/all.13947
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.
引用
收藏
页码:14 / 32
页数:19
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