Effectiveness of Dietary Allergen Exclusion Therapy on Eosinophilic Colitis in Chinese Infants and Young  Children ≤ 3 Years of Age

Yang, Min; Geng, Lanlan; Chen, Peiyu; Wang, Fenghua; Xu, Zhiqiang; Liang, Cuiping; Li, Huiwen; Fang, Tiefu; Friesen, Craig A.; Gong, Sitang; Li, Ding‐You

doi:10.3390/nu7031817

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…The IgE concentration associated with allergen stimulation does not reflect the tissue concentration at the location of the ongoing allergic inflammation. This suggests that most of the eosinophilic inflammation in the colon is associated with an IgE-independent mechanism [ 49 ]. The diagnosis is established by the presence of an increased eosinophilic infiltrate in the colon wall in symptomatic patients.…”

Section: Clinical Features Of Non-ige Gastrointestinal Famentioning

confidence: 99%

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

et al. 2021

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non-IgE and mixed gastrointestinal food allergies present various specific, well-characterized clinical pictures such as food protein-induced allergic proctocolitis, food protein-induced enterocolitis and food protein-induced enteropathy syndrome as well as eosinophilic gastrointestinal disorders such as eosinophilic esophagitis, allergic eosinophilic gastroenteritis and eosinophilic colitis. The aim of this article is to provide an updated review of their different clinical presentations, to suggest a correct approach to their diagnosis and to discuss the usefulness of both old and new diagnostic tools, including fecal biomarkers, atopy patch tests, endoscopy, specific IgG and IgG4 testing, allergen-specific lymphocyte stimulation test (ALST) and clinical score (CoMiss).

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Section: Clinical Features Of Non-ige Gastrointestinal Famentioning

confidence: 99%

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

et al. 2021

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“…In one study, forty-nine children were identified with eosinophilic colitis. Elemental formula, simple elimination diet (elemental formula for infants who were on formula feeding or dietary elimination of milk, egg, peanut and wheat for those who were not on formula feeding) or combination therapy resulted in clinical improvement in 75%, 88.2% and 80% of patients, respectively [ 17 ]. In a study by Stamm et al the use of a strict elemental diet for 3 months prior to endoscopy was not associated with a decreased frequency of eosinophilic inflammation in any tissue, which did not match the results of our study [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Association of fecal calprotectin level with eosinophilic gastrointestinal disease in Iranian pediatrics

Rohani

Beheshti

Alimadadi

et al. 2022

Allergy Asthma Clin Immunol

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Introduction Fecal calprotectin (FC) is a noninvasive biomarker for assessing the inflammatory status of the gastrointestinal tract. The aim of this study was to determine the association between FC levels and Eosinophilic colitis (EC) before and after treatment in pediatrics. Method In this cross-sectional study, 330 patients with rectorrhagia and FC levels > 200 μg/g were included in the study. Patients were then subjected to colonoscopy, and if 30 or more eosinophils were observed in the pathology of at least two parts of the colon, EC was diagnosed. Of the 330 patients included in the study, 14 patients were diagnosed as EC. Treatment included seven food elimination diet (food allergens) for 3 months. After 3 months, FC levels were repeated and colonoscopy was performed. Results The mean age of the children was 5.9 years. After the elimination diet, the number of eosinophils in all segments of colon significantly decreased (P < 0.001) and according to the pathology report, the number of eosinophils improved in 42.9% of patients. Also, the mean number of segments involved in the colon of patients was significantly decreased (P < 0.001). Mean FC levels were significantly decreased after 3 months (P < 0.001). The cut-off point of 114 μg/g of FC had sensitivity (75%), specificity (67%), positive predictive value (75%), negative predictive value (67%), accuracy (71.4%), and area under the ROC curve (0.708) acceptable in predicting EC. Conclusion This study showed that FC levels can be elevated in patients with EC, which is easily corrected with a targeted elimination of food allergens.

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“…Data regarding CMA in EGIDs are minimal and likely to reflect the lack of clarity regarding the diagnostic criteria largely resulting from a paucity of normative reference values for eosinophil counts in the GI tract. There are reports about the improvement of EGIDs by elimination of CM (see specific comorbidities and (57–63)). It is outside the remit of this paper to describe EGIDs in any more detail and their diagnosis and management is well reviewed in other articles (64,65).…”

Section: Clinical Gastro‐intestinal Presentation Of Cmamentioning

confidence: 99%

An ESPGHAN Position Paper on the Diagnosis, Management, and Prevention of Cow's Milk Allergy

Vandenplas

Broekaert

Domellöf

et al. 2024

J. pediatr. gastroenterol. nutr.

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A previous guideline on cow's milk allergy (CMA) developed by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) was published in 2012. This position paper provides an update on the diagnosis, treatment, and prevention of CMA with focus on gastrointestinal manifestations. All systematic reviews and meta-analyses regarding prevalence, pathophysiology, symptoms, and diagnosis of CMA published after the previous ESPGHAN document were considered. Medline was searched from inception until May 2022 for topics that were not covered in the previous document. After reaching consensus on the manuscript, statements were formulated and voted on each of them with a score between 1 and 9. A score of ≥6 was arbitrarily considered as agreement. Available evidence on the role of dietary practice in the prevention, diagnosis and management of CMA was updated and recommendations formulated. CMA in exclusively breastfed infants exists, but is uncommon and suffers from over-diagnosis. CMA is also over-diagnosed in formula and mixed fed infants. Changes in stool characteristics, feeding aversion or occasional spots of blood in stool are common and in general should not be considered as diagnostic of CMA, irrespective of preceding consumption of cow's milk. Over-diagnosis of CMA occurs much more frequently than under-diagnosis; both have potentially harmful consequences. Therefore, the necessity of a challenge test after a short diagnostic elimination diet of 2-4 weeks is recommended as the cornerstone of the diagnosis. This position paper contains sections on nutrition, growth, cost and quality of life.

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Effectiveness of Dietary Allergen Exclusion Therapy on Eosinophilic Colitis in Chinese Infants and Young Children ≤ 3 Years of Age

Cited by 7 publications

References 29 publications

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

Association of fecal calprotectin level with eosinophilic gastrointestinal disease in Iranian pediatrics

An ESPGHAN Position Paper on the Diagnosis, Management, and Prevention of Cow's Milk Allergy

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