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Morphology of the jejunum in children with eczema due to food allergy
Insights
Children with eczema from food allergies show reduced villus/crypt ratio in jejunal biopsies, indicating potential gastrointestinal changes. This study highlights subtle morphometric alterations in pediatric food allergy.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Gastrointestinal Pathology
Background:
- Eczema in children is often linked to food allergies.
- Gastrointestinal manifestations can accompany allergic reactions.
- Morphometric analysis of jejunal biopsies can reveal underlying pathology.
Purpose of the Study:
- To investigate jejunal morphometric changes in children with food allergy-induced eczema.
- To compare these changes with healthy controls.
- To correlate findings with clinical symptoms.
Main Methods:
- Morphometric analysis of jejunal biopsy specimens.
- Comparison between 18 children with food allergy and 13 age-matched controls.
- Categorization of patients based on symptoms (skin only vs. skin and gastrointestinal).
Main Results:
- A significant decrease in the villus/crypt ratio was observed in children with food allergies, primarily due to increased crypt depth.
- Lymphocyte and plasma cell counts in the lamina propria, and intraepithelial lymphocytes, were similar to controls.
- Increased jejunal eosinophils were noted in a subset of patients, but not significant overall.
Conclusions:
- Food allergy in children with eczema is associated with altered jejunal morphology, specifically a reduced villus/crypt ratio.
- These changes suggest a subclinical gastrointestinal impact of food allergies.
- Further research is needed to understand the clinical significance of these morphometric findings.
Abstract:
We report the results of a morphometric study of jejunal biopsy specimens from 18 children with eczema due to food allergy. The measurements were compared with those for 13 age-matched children without gastrointestinal or immunological diseases. The patients' ages ranged from 2 months to 4 years. In 14 the food responsible for the symptoms was cow's milk. During the challenge tests with suspected foods 10 children had skin symptoms only (group I) and eight had gastrointestinal symptoms in addition (group II). Both groups showed a significant decrease in the villus/crypt ratio, mostly due to an increase in crypt depth. The counts of lymphocytes and plasma cells in the lamina propria and of intraepithelial lymphocytes did not differ from those seen in the controls. Four patients had increased counts of jejunal eosinophils, but the mean count for the whole group was not significantly increased. Considered nine measurements only five of the patients had moderate changes in jejunal morphology.