诊断和管理食物蛋白诱导的过敏性肠道炎
Mahala Leney1, Francesca Kahale2, Victoria M Martin3
1Brown University, Providence, RI, USA.
Current gastroenterology reports
|December 16, 2025
概括
婴儿的食物蛋白诱导过敏性口腔炎 (FPIAP) 往往被过度诊断. 以挑战为基础的方法,包括最不严格的饮食和更早的重新引入,可以改善结果并支持母乳养.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 过敏 免疫学 免疫学
- 临床营养学 临床营养学
背景情况:
- 食物蛋白诱导的过敏性口腔炎 (FPIAP) 是婴儿直肠出血的常见原因.
- 目前FPIAP的诊断和管理实践差异很大,导致过度诊断和不必要的饮食限制.
- 干扰母乳养是与当前FPIAP管理相关的重大问题.
研究的目的:
- 审查当前的证据,以实用,以挑战为基础的FPIAP诊断和管理方法.
- 在FPIAP中指导临床医生尽量减少过度诊断和不必要的饮食限制.
- 支持持续母乳养和最佳婴儿营养.
主要方法:
- 临床诊断基于消除食物后症状的消失和重新引入后的复发.
- 对诊断生物标志物和管理策略的当代证据的审查.
- 强调对饮食干预的挑战证明的FPIAP.
主要成果:
- 尽管FPIAP是黄金标准,但对FPIAP的确认挑战很少进行.
- 拟议的生物标志物 (便calprotectin,埃索诺菲尔衍生的神经毒素,zonulin,微生物群签名) 在婴儿临床使用中缺乏可靠性.
- 最少的限制性饮食 (母体排泄,水解配方) 仅推给经过挑战的FPIAP.
- 早些时候重新引入触发性食物和引入其他过敏原可能会降低未来的过敏风险.
- 一种标准化,经过挑战验证的方法将过度限制降到最低,并支持母乳养.
结论:
- 基于挑战的诊断框架对于准确的FPIAP诊断和管理至关重要.
- 最少限制性饮食干预措施应保留给已确认的FPIAP病例.
- 未来的研究应该专注于验证非侵入性生物标志物和优化饮食再引入策略.
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