Noimark Lee, Cox Helen E
Department of Paediatric Allergy and Immunology, St Mary's Hospital NHS Trust, London, UK.
Pediatr Allergy Immunol. 2008 Mar;19(2):188-95. doi: 10.1111/j.1399-3038.2007.00700.x.
Food allergy is becoming an increasing problem worldwide with an estimated 6-8% of children affected at some point in their childhood. The perceived prevalence of food allergy is even higher with an estimated 20% of children adhering to some form of elimination diet. Against this background, accurate diagnosis is essential to prevent the imposition of unnecessarily restrictive diets on young children. Raising clinical awareness amongst health professionals as to the clinical characteristics, epidemiology, investigation, and management of food allergic disorders is key to tackling this growing problem. In this article, three separate cases of children with poor nutrition and secondary morbidity are presented, highlighting the varying scenarios in which these conditions can be encountered. In the first child, the features clinically displayed were hypocalcemic seizures and rickets due to prolonged breast feeding, poor weaning, and inadequate dietary supplementation. The second case reveals the dangers of complementary diagnostic allergy testing leading to poor nutrition as a consequence of an unsupervised elimination diet. The last report describes a child with multiple food allergies, failure to thrive, and protein losing enteropathy to highlight the diversity of nutritional problems faced by allergists and to underline the importance of specialist dietetic input in the management of a child with food allergy.
食物过敏在全球范围内正成为一个日益严重的问题，估计有6% - 8%的儿童在童年的某个阶段受到影响。食物过敏的感知患病率甚至更高，估计有20%的儿童坚持某种形式的排除饮食。在此背景下，准确诊断对于防止对幼儿实施不必要的限制性饮食至关重要。提高卫生专业人员对食物过敏疾病的临床特征、流行病学、检查和管理的认识，是解决这一日益严重问题的关键。本文介绍了三例营养状况不佳和继发疾病的儿童病例，突出了可能遇到这些情况的不同场景。在第一个孩子中，临床上表现出的特征是由于长期母乳喂养、断奶不佳和饮食补充不足导致的低钙惊厥和佝偻病。第二个病例揭示了辅助诊断性过敏检测的危险性，即由于无监督的排除饮食导致营养不良。最后一份报告描述了一名患有多种食物过敏、发育不良和蛋白丢失性肠病的儿童，以突出过敏症专科医生所面临的营养问题的多样性，并强调专科饮食指导在食物过敏儿童管理中的重要性。
