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食物蛋白诱导的小肠结肠炎综合征的诊断与管理策略:当前观点

Diagnostic and Management Strategies of Food Protein-Induced Enterocolitis Syndrome: Current Perspectives.

作者信息

Mulé Angela, Prattico Catherine, Al Ali Adnan, Mulé Pasquale, Ben-Shoshan Moshe

机构信息

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.

出版信息

Pediatric Health Med Ther. 2023 Oct 24;14:337-345. doi: 10.2147/PHMT.S404779. eCollection 2023.

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a form of non-IgE mediated food allergy that presents with delayed gastrointestinal symptoms after ingestion of the trigger food. The data regarding FPIES are sparse, despite being recognized as a distinct clinical entity. This narrative review presents the characteristics of this disorder in the pediatric population, as well-standard diagnostic and management protocols. FPIES can be classified into acute and chronic subtypes, and some cases may develop into an IgE-mediated allergy. Given that skin prick tests and specific IgE levels are negative in the majority of cases, diagnosis relies on clinical history and oral food challenges. Management involves elimination diets, assessment of tolerance through oral food challenges, and rehydration in the event of a reaction. Future research should focus on improving diagnostic methods, illustrating underlying pathogenesis and biomarkers, and assessing long-term natural history. Increased knowledge and awareness for FPIES are required.

摘要

食物蛋白诱导的小肠结肠炎综合征(FPIES)是一种非IgE介导的食物过敏形式,在摄入触发食物后会出现延迟性胃肠道症状。尽管FPIES已被确认为一种独特的临床实体,但其相关数据却很稀少。本叙述性综述介绍了该疾病在儿科人群中的特征以及标准的诊断和管理方案。FPIES可分为急性和慢性亚型,部分病例可能发展为IgE介导的过敏。鉴于大多数病例的皮肤点刺试验和特异性IgE水平均为阴性,诊断依赖于临床病史和口服食物激发试验。管理措施包括饮食回避、通过口服食物激发试验评估耐受性以及在发生反应时进行补液。未来的研究应侧重于改进诊断方法、阐明潜在的发病机制和生物标志物,以及评估长期自然病程。需要提高对FPIES的认识和了解。

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A Systematic Review of Food Protein-Induced Enterocolitis Syndrome.食物蛋白诱导的结肠炎综合征的系统评价
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Update on Food Protein-Induced Enterocolitis Syndrome (FPIES).食物蛋白诱导的肠病综合征(FPIES)更新。
Curr Allergy Asthma Rep. 2022 Oct;22(10):113-122. doi: 10.1007/s11882-022-01037-y. Epub 2022 May 6.
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Pathophysiology of Non-IgE-Mediated Food Allergy.非IgE介导的食物过敏的病理生理学
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