Poza-Guedes Paloma, Barrios Yvelise, González-Pérez Ruperto, Sánchez-Machín Inmaculada, Franco Andres, Matheu Víctor
Consulta de Alergia Infantil, Unidad de Alergología-Norte, Hospital del Tórax/Ofra, CHUNSC, Sta. Cruz de Tenerife, 38320 Spain.
Immunology, Hospital Universitario de Canarias, La Laguna, Spain.
Allergy Asthma Clin Immunol. 2016 Feb 23;12:7. doi: 10.1186/s13223-016-0111-7. eCollection 2016.
The prevalence of many phenotypes of food allergy is increasing. Specific gastrointestinal (GI) phenotype of food allergy (GI allergy) is also increasing but it is difficult to know the prevalence because of many entities. METHODS AND RESULTS: A 1 year retrospective study of pediatric patients complaining exclusively gastrointestinal symptoms after cow's milk consumption and at least one positive specific IgE (sIgE) to cow's milk (CM) proteins (CMP) was done (n = 39). The most prevalent symptom was abdominal cramps in 35 patients (90 %), discomfort or abdominal distention in 30 patients (75 %), diarrhea in 10 patients (25 %) and constipation in 5 patients (12 %). IgA anti-transglutaminase antibodies were absent and lactose intolerance was ruled out in all patients. Average of total IgE on this group was 288 UI/ml. sIgE against β-lactoglobulin was the dominant with an average of 4.14 kU/l. sIgE to casein (CAS), which is the dominant protein in systemic anaphylaxis was 1.74 kU/l; sIgE to α-lactoalbumin, the other whey protein, was 0.83 kU/l and sIgE levels to CM were 0.78 kU/l. The quotient sIgE CAS/sIgE β-lactoglobulin in these patients was always lower than 1. Patients experienced an improvement of their symptoms after a CM free diet. An open oral challenge with CM did mimic their initial symptoms in all patients. However, the open oral challenge with dairy products was well tolerated.
Patients with a specific phenotype of GI allergy with CM have specific IgE against β-lactoglobulin, as a dominant sIgE. These patients could beneficiate of a diet with dairy products.
许多食物过敏表型的患病率正在上升。食物过敏的特定胃肠道（GI）表型（GI过敏）也在增加，但由于存在多种情况，很难了解其患病率。
对仅在食用牛奶后出现胃肠道症状且至少对牛奶（CM）蛋白（CMP）有一项阳性特异性IgE（sIgE）的儿科患者进行了为期1年的回顾性研究（n = 39）。最常见的症状是35例患者（90%）出现腹部绞痛，30例患者（75%）有不适或腹胀，10例患者（25%）出现腹泻，5例患者（12%）出现便秘。所有患者均未检测到IgA抗转谷氨酰胺酶抗体，且排除了乳糖不耐受。该组患者的总IgE平均为288 UI/ml。针对β-乳球蛋白的sIgE占主导，平均为4.14 kU/l。系统性过敏反应中的主要蛋白酪蛋白（CAS）的sIgE为1.74 kU/l；另一种乳清蛋白α-乳白蛋白的sIgE为0.83 kU/l，CM的sIgE水平为0.78 kU/l。这些患者中sIgE CAS/sIgEβ-乳球蛋白的比值始终低于1。患者在无CM饮食后症状有所改善。对CM进行的开放性口服激发试验在所有患者中均重现了其初始症状。然而，对乳制品进行的开放性口服激发试验耐受性良好。
患有CM特异性GI过敏表型的患者具有针对β-乳球蛋白的特异性IgE，作为主要的sIgE。这些患者可以从食用乳制品的饮食中获益。
