Related Experiment Video
Updated: Jul 24, 2025
Mouse Body Temperature Measurement Using Infrared Thermometer During Passive Systemic Anaphylaxis and Food Allergy Evaluation
Published on: September 14, 2018
A different starting line for allergic march: food protein-induced allergic proctocolitis
Semiha Bahceci1, Pınar Kuyum Töz2, Figen Celebi Celik3
1Department of Pediatric Allergy and Immunology, Çiğli Training and Research Hospital, Izmir Bakırçay University, Faculty of Medicine, Izmir, Turkey.
Insights
Food protein-induced allergic proctocolitis (FPIAP) patients have an increased risk of developing long-term allergic diseases and functional gastrointestinal disorders (FGIDs). Early tolerance development is crucial for better outcomes, as delayed tolerance is linked to higher FGID and allergic disease prevalence.
Area of Science:
- Pediatric Allergy and Immunology
- Gastroenterology
- Clinical Nutrition
Background:
- Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE mediated gastrointestinal food allergy in infants.
- Long-term outcomes and the risk of developing other allergic or gastrointestinal diseases in FPIAP patients are not well-established.
- Understanding the trajectory of FPIAP is crucial for identifying potential risk factors for the allergic march.
Purpose of the Study:
- To investigate the long-term prognosis of children diagnosed with FPIAP.
- To assess the risk of developing comorbid allergic and gastrointestinal diseases in FPIAP patients.
- To determine if FPIAP contributes to the development of the allergic march.
Main Methods:
- A cohort study involving 149 children with a history of FPIAP (tolerant for at least 5 years) and 41 healthy controls.
- Comprehensive re-evaluation for allergic diseases and gastrointestinal disorders in both groups.
- Analysis of disease development in relation to age of FPIAP diagnosis, age of tolerance, and presence of comorbidities.
Main Results:
- FPIAP patients showed a significantly higher incidence of comorbid allergic diseases compared to controls (P < 0.001).
- No significant differences were observed in the prevalence of functional gastrointestinal disorders (FGIDs), eosinophilic gastrointestinal diseases, or inflammatory bowel disease between groups.
- Delayed tolerance development (>18 months) in FPIAP patients was associated with a significantly higher proportion of both FGIDs and allergic diseases (P < 0.001).
Conclusions:
- FPIAP patients are at an increased risk for developing allergic diseases and FGIDs later in life.
- The development of allergic diseases in FPIAP patients is associated with the presence of allergic disease at diagnosis.
- Delayed tolerance to food proteins in FPIAP is a significant risk factor for long-term gastrointestinal and allergic morbidities.
Objective:
The aim of this study is to investigate the long-term prognosis of food protein--induced allergic proctocolitis (FPIAP) patients, the risk of developing both allergic and gastrointestinal diseases, and to evaluate whether it leads to allergic march.
Methods:
A total of 149 children who were diagnosed with FPIAP and developed tolerance at least 5 years prior to the study and 41 children (with no history of food allergy) as a control group were enrolled. Both groups were re-evaluated for allergic diseases as well as gastrointestinal disorders.
Results:
The mean age of diagnosis for the FPIAP group was 4.2 ± 3.0 months, while the mean age of tolerance was 13.9 ± 7.7 months. The mean age of both FPIAP and control groups at the last visit was 101.6 ± 24.4 and 96.3 ± 24.1 months, respectively (P = 0.213). At the final evaluation of both groups, the comorbid allergic disease was significantly higher in the FPIAP group (P < 0.001). There was no significant difference between the two groups in terms of functional gastrointestinal disorders (FGIDs), eosinophilic gastrointestinal diseases, and inflammatory bowel disease (P = 0.198, 0.579, and 0.579, respectively).In the FPIAP group, the allergic disease was significantly higher at the final visit in patients with comorbid allergic disease at diagnosis (P < 0.001). In the FPIAP group, FGID was significantly higher in the group that developed allergic diseases in the future, compared to the group that did not develop allergic diseases in the future (P = 0.034). The proportion of both FGID and allergic diseases was significantly higher in subjects that developed tolerance at >18 months, compared to subjects that developed tolerance at >18 months (P < 0.001 and <0.001, respectively).
Conclusions:
Patients with FPIAP may develop allergic diseases as well as FGID in the long term.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
02:06Allergic Reactions
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:27Allergic Drug Reactions
01:29Drugs for Treatment of Ulcerative Colitis in IBD
01:21Drugs for Treatment of Constipation-Predominant IBS