A nationwide survey of non-IgE-mediated gastrointestinal food allergies in neonates and infants.

Journal

Allergology international : official journal of the Japanese Society of Allergology
ISSN: 1440-1592
Titre abrégé: Allergol Int
Pays: England
ID NLM: 9616296

Informations de publication

Date de publication:
30 Oct 2023
Historique:
received: 20 06 2023
revised: 24 09 2023
accepted: 06 10 2023
medline: 2 11 2023
pubmed: 2 11 2023
entrez: 1 11 2023
Statut: aheadofprint

Résumé

Non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFAs) seem to be increasing rapidly worldwide. However, nationwide studies have been limited to food-protein-induced enterocolitis (FPIES) and food-protein-induced allergic proctocolitis (FPIAP), with little attention to other non-IgE-GIFA subgroups. The aim of this study was to elucidate the clinical features of all patients with non-IgE-GIFAs, not just certain subgroups. We conducted a nationwide cross-sectional survey of non-IgE-GIFAs in Japan from April 2015 through March 2016. A questionnaire was sent to hospitals and clinics throughout Japan. The questionnaire asked about the number of physician-diagnosed non-IgE-GIFA patients, the status of fulfillment of the diagnostic criteria, tentative classification into 4 clusters based on the initial symptoms, the day of onset after birth, complications, and the suspected offending food(s). The response rate to that questionnaire was 67.6% from hospitals and 47.4% from clinics. Analyses were conducted about "diagnosis-probable" patient cohort (n = 402) and the "diagnosis-confirmed" patients (n = 80). In half of the reported non-IgE-GIFA patients, onset occurred in the neonatal period. The patients were evenly distributed among 4 non-IgE-GIFA clusters. In Cluster 1, with symptoms of vomiting and bloody stool, the onset showed a median of 7 days after birth, which was the earliest among the clusters. Cow's milk was the most common causative food. In half of the patients, the onset of non-IgE-GIFAs was in the neonatal period. This highlights the importance of studying the pathogenesis in the fetal and neonatal periods.

Sections du résumé

BACKGROUND BACKGROUND
Non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFAs) seem to be increasing rapidly worldwide. However, nationwide studies have been limited to food-protein-induced enterocolitis (FPIES) and food-protein-induced allergic proctocolitis (FPIAP), with little attention to other non-IgE-GIFA subgroups. The aim of this study was to elucidate the clinical features of all patients with non-IgE-GIFAs, not just certain subgroups.
METHODS METHODS
We conducted a nationwide cross-sectional survey of non-IgE-GIFAs in Japan from April 2015 through March 2016. A questionnaire was sent to hospitals and clinics throughout Japan. The questionnaire asked about the number of physician-diagnosed non-IgE-GIFA patients, the status of fulfillment of the diagnostic criteria, tentative classification into 4 clusters based on the initial symptoms, the day of onset after birth, complications, and the suspected offending food(s).
RESULTS RESULTS
The response rate to that questionnaire was 67.6% from hospitals and 47.4% from clinics. Analyses were conducted about "diagnosis-probable" patient cohort (n = 402) and the "diagnosis-confirmed" patients (n = 80). In half of the reported non-IgE-GIFA patients, onset occurred in the neonatal period. The patients were evenly distributed among 4 non-IgE-GIFA clusters. In Cluster 1, with symptoms of vomiting and bloody stool, the onset showed a median of 7 days after birth, which was the earliest among the clusters. Cow's milk was the most common causative food.
CONCLUSIONS CONCLUSIONS
In half of the patients, the onset of non-IgE-GIFAs was in the neonatal period. This highlights the importance of studying the pathogenesis in the fetal and neonatal periods.

Identifiants

DOI: 10.1016/j.alit.2023.10.003 PMID: 37914545
pubmed: 37914545
pii: S1323-8930(23)00107-7
doi: 10.1016/j.alit.2023.10.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.

Auteurs

Hiroko Suzuki (H)

National Research Institute for Child Health and Development, Division of Eosinophilic Gastrointestinal Disorders, Tokyo, Japan; Todachuo General Hospital, Department of Pediatrics, Saitama, Japan.

Naho Morisaki (N)

National Center for Child Health and Development, Department of Social Medicine, Tokyo, Japan.

Saori Nagashima (S)

National Research Institute for Child Health and Development, Division of Eosinophilic Gastrointestinal Disorders, Tokyo, Japan.

Tamotsu Matsunaga (T)

Todachuo General Hospital, Department of Pediatrics, Saitama, Japan.

Shoko Matsushita (S)

Tokyo Metropolitan Children's Medical Center, Department of Allergy, Tokyo, Japan.

Akira Iino (A)

Tokyo Metropolitan Children's Medical Center, Department of Allergy, Tokyo, Japan.

Yuichiro Tanaka (Y)

National Center for Child Health and Development, Department of General Pediatrics and Interdisciplinary Medicine, Tokyo, Japan.

Hisashi Nishimori (H)

Mie Prefectural General Medical Center, Department of Pediatrics, Mie, Japan.

Shun Munakata (S)

Nagano Children's Hospital, Department of Neonatology, Nagano, Japan.

Manabu Kemmochi (M)

Kitasato University Hospital, Department of Pediatrics, Kanagawa, Japan.

Yoshitaka Murakami (Y)

Ehime Prefectural Imabari Hospital, Department of Pediatrics, Ehime, Japan.

Miori Sato (M)

National Center for Child Health and Development, Allergy Center, Tokyo, Japan.

Kenji Toyokuni (K)

National Center for Child Health and Development, Allergy Center, Tokyo, Japan.

Kiwako Yamamoto-Hanada (K)

National Center for Child Health and Development, Allergy Center, Tokyo, Japan.

Hideaki Morita (H)

National Research Institute for Child Health and Development, Department of Allergy and Clinical Immunology, Tokyo, Japan.

Tatsuki Fukuie (T)

National Center for Child Health and Development, Allergy Center, Tokyo, Japan.

Yoshiyuki Yamada (Y)

Tokai University School of Medicine, Department of Pediatrics, Kanagawa, Japan.

Yoshikazu Ohtsuka (Y)

Juntendo University School of Medicine, Department of Pediatrics and Adolescent Medicine, Tokyo, Japan.

Katsuhiro Arai (K)

National Center for Child Health and Development, Allergy Center, Tokyo, Japan; National Center for Child Health and Development, Division of Gastroenterology, Tokyo, Japan.

Yukihiro Ohya (Y)

National Center for Child Health and Development, Allergy Center, Tokyo, Japan.

Hirohisa Saito (H)

National Research Institute for Child Health and Development, Department of Allergy and Clinical Immunology, Tokyo, Japan.

Kenji Matsumoto (K)

National Research Institute for Child Health and Development, Department of Allergy and Clinical Immunology, Tokyo, Japan.

Ichiro Nomura (I)

National Research Institute for Child Health and Development, Division of Eosinophilic Gastrointestinal Disorders, Tokyo, Japan; National Center for Child Health and Development, Allergy Center, Tokyo, Japan. Electronic address: nomura-i@ncchd.go.jp.

Classifications MeSH