Evaluation of liver function tests in children with food allergies

The aim of this study was to investigate liver function tests and their association with clinical characteristics in children diagnosed with non-IgE-mediated food allergy. A total of 132 children with non-IgE-mediated food allergies and 127 age- and sex-matched healthy controls were retrospectively analyzed. Patient demographics, clinical features and response to treatment were analyzed. Serum aspartate aminotransferase and alanine aminotransferase (ALT) levels were measured in both groups. The mean age of the patients was 6.0 ± 3.2 months, and symptoms appeared on average at 4.0 ± 3.4 months. At the time of symptom onset, 69 children (52.2%) were exclusively breastfed. The most common symptoms were mucous (56.8%) and bloody stools (47%). Food protein-induced proctocolitis was diagnosed in 104 patients (78.8%), food protein-induced enterocolitis syndrome in 18 (13.6%) and food protein-induced enteropathy in 10 (7.6%). Cow's milk (86.3%) and egg (34%) were the most common allergens. Mean ALT levels were significantly higher in patients (35.1 ± 30.6 U/L) than in controls (23.2 ± 8.6 U/L; P = .009), and ALT elevation was observed in 10.6% of patients versus 3.1% of controls (P = .026). Transaminase levels normalized on average within 3.9 ± 1.4 months after diet elimination. No significant differences were observed between children with elevated and normal ALT levels with respect to age, gender, diet, diagnosis or atopy. A mild elevation of liver enzyme may occur in children with non-IgE-mediated food allergies and usually disappears with elimination of the food. Clinicians should consider this association at diagnosis and delay invasive interventions until dietary intervention has been attempted.