Allergic Rhinitis in Children with Food Protein-Induced Allergic Proctocolitis - EMJ

Allergic Rhinitis in Children with Food Protein-Induced Allergic Proctocolitis

A RECENT study from the Pediatric Allergy Department of Hacettepe University, presented at this year’s European Academy of Allergy and Clinical Immunology (EAACI) Congress, has shed light on the prevalence of asthma and allergic rhinitis in children with a history of Food Protein-Induced Allergic Proctocolitis (FPIAP). FPIAP is a non-immunoglobulin E (IgE)-mediated food allergy that manifests during infancy, characterized by blood and mucus in the stool. This condition, despite its potential role in the atopic march, has been understudied.

The cross-sectional study included 154 children previously diagnosed with FPIAP and compared them to 100 children with IgE-mediated cow’s milk allergy (IgE-MA). Researchers evaluated the development of asthma and allergic rhinitis in both groups.

The study found that the median age of FPIAP diagnosis was five months, with most children developing tolerance by 12 months. Cow’s milk was the primary trigger for FPIAP, though 39% of patients reacted to multiple foods. At the time of enrollment, the median ages were 7.4 years for the FPIAP group and 7.0 years for the IgE-MA group.

Asthma and allergic rhinitis were diagnosed in 28.5% and 45.4% of the FPIAP group, respectively. In contrast, the IgE-MA group exhibited a significantly higher asthma incidence (65% vs. 45.4%, p=0.002). The frequency of lifetime wheezes was also greater in the FPIAP group, with those diagnosed with asthma at their most recent visit showing higher wheeze frequency (5 vs. 3, p=0.001).

Regarding asthma treatment, children in the IgE-MA group were more likely to use inhaled steroids or leukotriene receptor antagonists (66.1% vs. 46.2%, p=0.02).

This study indicated that children with a history of FPIAP are at risk of developing asthma and allergic rhinitis as they grow older. The findings underscore the importance of early diagnosis and routine asthma screening for these patients to reduce morbidity. By implementing such screenings, healthcare providers can better manage and mitigate the long-term impacts of FPIAP on children’s health.

 

Reference

Kazancioglu A. Food Protein Induced Allergic Proctocolitis as a Component of the Allergic March. Poster. EAACI Annual Meeting, 31 May-3 June 2024.

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