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

  • Suzuki Hiroko
    National Research Institute for Child Health and Development, Division of Eosinophilic Gastrointestinal Disorders Todachuo General Hospital, Department of Pediatrics
  • Morisaki Naho
    National Center for Child Health and Development, Department of Social Medicine
  • Nagashima Saori
    National Research Institute for Child Health and Development, Division of Eosinophilic Gastrointestinal Disorders
  • Matsunaga Tamotsu
    Todachuo General Hospital, Department of Pediatrics
  • Matsushita Shoko
    Tokyo Metropolitan Children's Medical Center, Department of Allergy
  • Iino Akira
    Tokyo Metropolitan Children's Medical Center, Department of Allergy
  • Tanaka Yuichiro
    National Center for Child Health and Development, Department of General Pediatrics and Interdisciplinary Medicine
  • Nishimori Hisashi
    Mie Prefectural General Medical Center, Department of Pediatrics
  • Munakata Shun
    Nagano Children's Hospital, Department of Neonatology
  • Kemmochi Manabu
    Kitasato University Hospital, Department of Pediatrics
  • Murakami Yoshitaka
    Ehime Prefectural Imabari Hospital, Department of Pediatrics
  • Sato Miori
    National Center for Child Health and Development, Allergy Center
  • Toyokuni Kenji
    National Center for Child Health and Development, Allergy Center
  • Yamamoto-Hanada Kiwako
    National Center for Child Health and Development, Allergy Center
  • Morita Hideaki
    National Research Institute for Child Health and Development, Department of Allergy and Clinical Immunology
  • Fukuie Tatsuki
    National Center for Child Health and Development, Allergy Center
  • Yamada Yoshiyuki
    Tokai University School of Medicine, Department of Pediatrics
  • Ohtsuka Yoshikazu
    Juntendo University School of Medicine, Department of Pediatrics and Adolescent Medicine
  • Arai Katsuhiro
    National Center for Child Health and Development, Allergy Center National Center for Child Health and Development, Division of Gastroenterology
  • Ohya Yukihiro
    National Center for Child Health and Development, Allergy Center
  • Saito Hirohisa
    National Research Institute for Child Health and Development, Department of Allergy and Clinical Immunology
  • Matsumoto Kenji
    National Research Institute for Child Health and Development, Department of Allergy and Clinical Immunology
  • Nomura Ichiro
    National Research Institute for Child Health and Development, Division of Eosinophilic Gastrointestinal Disorders National Center for Child Health and Development, Allergy Center

抄録

<p>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.</p><p>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).</p><p>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.</p><p>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.</p>

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