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Single and multiple food allergies in infants with proctocolitis
B T Koksal1, Z Barıs2, F Ozcay2
1Department of Pediatrics, Division of Pediatric Allergy, Baskent University Faculty of Medicine, Ankara, Turkey.
Insights
Infants with multiple food allergies often show higher eosinophil counts and more positive allergy tests. These children may also experience persistent symptoms beyond two years of age.
Area of Science:
- Pediatric Allergy and Immunology
- Gastroenterology
- Immunology
Background:
- Food protein-induced allergic proctocolitis is a common cause of infant rectal bleeding.
- Characteristics of infants with multiple food allergies require further definition.
Purpose of the Study:
- Identify characteristics of infants diagnosed with proctocolitis.
- Compare infants with single versus multiple food allergies.
Main Methods:
- Retrospective evaluation of 132 infants diagnosed with proctocolitis.
- Data collected included clinical features, blood counts, skin prick tests, specific IgE, and stool/colonoscopy results.
- Diagnoses were confirmed by pediatric allergists/gastroenterologists.
Main Results:
- Cow's milk and egg were the most frequent allergens.
- 34.1% of infants had multiple food allergies.
- Infants with multiple food allergies exhibited higher eosinophil counts and more positive allergy test results (skin prick test/specific IgE).
- Persistent symptoms beyond age two were more common in infants with multiple food allergies.
Conclusions:
- Clinical presentation does not differentiate single from multiple food allergies in infants.
- Elevated blood eosinophil counts and positive allergy tests (skin prick test/specific IgE) are indicative of multiple food allergies in infants.
- Multiple food allergies are associated with persistent symptoms.
Background:
Food protein-induced allergic proctocolitis is a frequent cause of rectal bleeding in infants. Characteristics of infants with multiple food allergies have not been defined.
Objective:
This study aimed to identify characteristics of infants with proctocolitis and compare infants with single and multiple food allergies.
Methods:
A total of 132 infants with proctocolitis were evaluated retrospectively. All of the infants were diagnosed by a paediatric allergist and/or a paediatric gastroenterologist according to guidelines. Clinical features of the infants, as well as results of a complete blood count, skin prick test, specific immunoglobulin E, and stool examinations or colonoscopy were recorded.
Results:
Cow's milk (97.7%) was the most common allergen, followed by egg (22%). Forty-five (34.1%) infants had allergies to more than one food. Infants with multiple food allergies had a higher eosinophil count (613±631.2 vs. 375±291.9) and a higher frequency of positive specific IgE and/or positive skin prick test results than that of patients with a single food allergy. Most of the patients whose symptoms persisted after two years of age had multiple food allergies.
Conclusions:
There is no difference in clinical presentations between infants with single and multiple food allergies. However, infants with multiple food allergies have a high blood total eosinophil count and are more likely to have a positive skin prick test and/or positive specific IgE results.
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