Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, ChinaNursing Department, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Allergol Immunopathol (Madr). 2023 May 1;51(3):163-173. doi: 10.15586/aei.v51i3.738. eCollection 2023.
The non-IgE-mediated food allergy (non-IgE-FA) is less prevalent than IgE-mediated food allergy, and their relationship with functional constipation (FC) needs to be clarified.
A total of 305 infants and children with constipation treated in the Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, from July 2020 to December 2021 were included in this study. Four cases with organic lesions were excluded. Among 301 diagnosed with FC, according to ROME IV criteria, 81 cases with allergy-related indicators were further evaluated for food allergy by food-specific IgG antibody test, allergen- specific IgE antibody detection, skin prick test, and food avoidance and reintroduction.
A total of 45 cases with FC were diagnosed with food allergy, and the incidence rate was 15%. Among the 45 patients, 35 cases (77.8%) had FC with non-IgE-FA. The main clinical symptoms or signs included anal fissure, abdominal pain, and pain during defecation. The most prevalent allergic foods were cow's milk, eggs, fish, and shrimp. Ten (22.2%) cases reported FC with mixed food allergy, including both non-IgE-mediated and IgE-mediated food allergy. This study focused on non-IgE-mediated food allergy-related FC.
Our results showed that the incidence of food allergy in infants and children with FC was 15%, which was mainly mediated by non-IgE-FA. The main clinical symptoms or signs in these cases included anal fissure, abdominal pain, and pain during defecation, and the main allergens included milk, eggs, fish, and shrimp.
非 IgE 介导的食物过敏（non-IgE-FA）比 IgE 介导的食物过敏少见，其与功能性便秘（FC）的关系尚需阐明。
本研究纳入 2020 年 7 月至 2021 年 12 月在南京医科大学附属儿童医院儿科消化科就诊的 305 例便秘患儿，排除 4 例有器质性病变的患儿。在 301 例诊断为 FC 的患儿中，根据罗马 IV 标准，进一步对 81 例具有过敏相关指标的患儿进行食物过敏评估，包括食物特异性 IgG 抗体检测、过敏原特异性 IgE 抗体检测、皮肤点刺试验和食物回避与再引入。
共诊断 45 例 FC 合并食物过敏，发病率为 15%。这 45 例患儿中，35 例（77.8%）为非 IgE-FA 相关 FC，主要临床症状或体征包括肛裂、腹痛和排便时疼痛，主要过敏食物为牛奶、鸡蛋、鱼和虾。10 例（22.2%）患儿报告 FC 合并混合食物过敏，包括非 IgE 介导和 IgE 介导的食物过敏。本研究重点关注非 IgE 介导的食物过敏相关 FC。
我们的研究结果表明，FC 患儿食物过敏的发生率为 15%，主要由非 IgE-FA 介导。这些患儿的主要临床症状或体征包括肛裂、腹痛和排便时疼痛，主要过敏原包括牛奶、鸡蛋、鱼和虾。
