Department of Medicine I, University of Erlangen, Germany.
Allergy. 2012 Feb;67(2):286-92. doi: 10.1111/j.1398-9995.2011.02738.x. Epub 2011 Oct 28.
Food allergy may present with a plethora of gastrointestinal and extraintestinal symptoms such as abdominal pain, diarrhea, cardiocirculatory symptoms, cutaneous reactions, or rhinitis. Macropathological lesions like lymphofollicular hyperplasia and erosive or ulcerative lesions have seldom been described in gastroscopy and colonoscopy previously.
Fifteen patients presenting with unspecific abdominal symptoms in which food allergy was detected in due course were included. During the examination process, those patients showed various indications for small-bowel capsule endoscopy, such as weight loss and anemia.
Fourteen (93.3%) of the 15 small-bowel capsule endoscopies could be assessed, showing nonerosive lesions such as erythema, swelling, and lymphoid hyperplasia in 8 patients (57.1%) and erosive lesions such as aphthoid lesions, erosions, and petechiae in 4 patients (28.6%) with food allergy.
In 15 patients with confirmed food allergy and after exclusion of other diseases, 12 (85.7%) showed various unspecific nonerosive or erosive mucosal lesions within the small bowel, resulting, however, partially in grave consequences such as anemia. Lymphoid hyperplasia was the most prominent finding in 7 patients (50%), albeit infectious disease had been excluded. Anemia improved within 1 year after adequate antiallergic treatment.
食物过敏可能会出现多种胃肠道和肠外症状,如腹痛、腹泻、心血管症状、皮肤反应或鼻炎。以前在胃镜和结肠镜检查中很少描述过淋巴滤泡增生和糜烂或溃疡性病变等宏观病变。
纳入了 15 名出现非特异性腹部症状且随后发现食物过敏的患者。在检查过程中,这些患者出现了小肠胶囊内镜的各种指征,如体重减轻和贫血。
15 例小肠胶囊内镜中有 14 例(93.3%)可进行评估,其中 8 例(57.1%)有非侵蚀性病变,如红斑、肿胀和淋巴组织增生,4 例(28.6%)有侵蚀性病变,如口疮样病变、侵蚀和瘀点。
在 15 例确诊食物过敏且排除其他疾病的患者中,12 例(85.7%)在小肠内出现各种非特异性非侵蚀性或侵蚀性黏膜病变,但部分患者出现严重后果,如贫血。7 例(50%)患者以淋巴组织增生最为突出,尽管已排除传染病。在适当的抗过敏治疗后,贫血在 1 年内得到改善。