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Colonic lymphoid nodular hyperplasia in children: relationship to food hypersensitivity

Giuseppe Iacono1, Alberto Ravelli, Lidia Di Prima

  • 1Division of Pediatric Gastroenterology, Di Cristina Children's Hospital, Palermo, Italy.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|March 21, 2007
PubMed

Insights

Lymphoid nodular hyperplasia (LNH) in children undergoing colonoscopy is common and often linked to food hypersensitivity. This finding in the lower gastrointestinal tract may indicate delayed-type food allergy.

Area of Science:

  • Pediatric Gastroenterology
  • Allergy and Immunology
  • Gastrointestinal Pathology

Background:

  • The clinical significance of lymphoid nodular hyperplasia (LNH) in the lower gastrointestinal tract remains unclear.
  • Understanding LNH in pediatric patients is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To determine the frequency of LNH in children undergoing colonoscopy.
  • To investigate the clinical significance and associations of LNH in pediatric patients.

Main Methods:

  • Evaluated 245 children (median age 8.5 years) undergoing colonoscopy over 3 years.
  • Performed ileocolonoscopy with biopsy, routine biochemistry, IgE testing, and skin prick tests.
  • Patients with LNH underwent elimination diets and food challenges.

Main Results:

  • LNH was found in 30% of colonoscopies (73/245).
  • Food hypersensitivity (cow's milk or multiple foods) was diagnosed in 43/52 (71%) of LNH cases, significantly higher than in controls (83% vs 31%).
  • LNH with food hypersensitivity correlated with hematochezia, elevated anti-beta-lactoglobulin IgG, anemia, and failure to thrive.

Conclusions:

  • LNH of the colon and/or terminal ileum is a frequent finding in symptomatic children.
  • In the absence of other specific lesions, LNH is associated with delayed-type food hypersensitivity.
Abstract

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