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Long-term risk of allergic diseases after allergic proctocolitis: A clinical perspective
Alp Kazancioglu1, Cansu Ozdemiral1, Pinar Gur Cetinkaya1
1Pediatric Allergy Department, Hacettepe University School of Medicine, Ankara, Turkey.
Insights
Children with food protein-induced allergic proctocolitis (FPIAP) face a higher risk of developing asthma and allergic rhinitis (AR). Ongoing monitoring is crucial for these children to manage their long-term allergic conditions.
Area of Science:
- Pediatric Allergy and Immunology
- Gastroenterology
- Clinical Research
Background:
- The long-term allergic outcomes for children with a history of food protein-induced allergic proctocolitis (FPIAP) are not well-established.
- Understanding the progression of allergic conditions following FPIAP is essential for effective patient management.
Purpose of the Study:
- To determine the prevalence and clinical characteristics of allergic diseases, particularly asthma and allergic rhinitis (AR), in children with a history of FPIAP.
- To compare the risk of developing asthma and AR in FPIAP patients against control groups with different allergy histories.
Main Methods:
- A retrospective case-control study included 170 patients diagnosed with FPIAP.
- Control groups consisted of patients with non-food allergy (non-FA), outgrown IgE-mediated cow's milk allergy (IgE-CMA), and current IgE-CMA.
- Proportions of asthma and AR were compared across FPIAP and control groups.
Main Results:
- Patients with a history of FPIAP showed a significantly higher risk of developing asthma (aOR: 4.273) and AR (aOR: 3.039) compared to the non-FA group.
- The prevalence of asthma (45.2%) and AR (17.6%) was higher in the FPIAP group than in the non-FA group (12.9% and 5.9%, respectively).
- Asthma control was poorer in the FPIAP group compared to those with IgE-mediated cow's milk allergy.
Conclusions:
- Children with a history of FPIAP have an increased risk for developing asthma and allergic rhinitis.
- These findings highlight the need for continued surveillance and monitoring of allergic conditions in children with a history of FPIAP.
- Further research is warranted to elucidate the role of FPIAP in the broader context of the allergic march.
Background:
The long-term progression of allergic conditions in children with a history of food protein-induced allergic proctocolitis (FPIAP) remains unclear.
Objective:
To assess the prevalence and clinical characteristics of allergic diseases, particularly asthma, in patients with a history of FPIAP.
Methods:
In this retrospective case-control study, we included 170 patients diagnosed with having FPIAP (median age [IQR]: 7.4 [6.9-8.0] years) who developed tolerance at a median age of 12 months (IQR: 10.0-14.0). Control groups comprised patients with non-food allergy (non-FA; n = 101), outgrown IgE-mediated cow's milk allergy (IgE-CMA; n = 97), and current IgE-CMA (n = 100). The proportions of asthma and allergic rhinitis (AR) were compared among the groups.
Results:
The FPIAP group exhibited a higher risk of developing asthma and AR than the non-FA group did (asthma: adjusted odds ratio: 4.273, 95% CI: 2.173-8.403, P < .001; AR: adjusted odds ratio: 3.039, 95% CI: 1.199-7.692, P = .019). The proportions of asthma and AR in the FPIAP group (45.2% and 17.6%, respectively) were significantly higher than those in the non-FA group (12.9%, P < .001; 5.9%, P = .006) but lower than those in the current IgE-CMA group (74%, P < .001; 36%, P = .001). No significant differences were observed between the FPIAP and outgrown IgE-CMA groups. However, patients with FPIAP exhibited poorer asthma control than those in the IgE-mediated CMA groups did.
Conclusion:
Children with a history of FPIAP are at an increased risk of developing asthma and AR, necessitating ongoing monitoring. Further research is needed to clarify the role of FPIAP in the allergic march.
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