Gastrointestinal Manifestations of Food Allergy in Childhood

  • H. K. Harms
  • R. M. Bertele-Harms
Conference paper

Abstract

Reliable data on the frequency of food allergy and its gastrointestinal manifestations in childhood can only be gained by comprehensive, prospective field studies. Furthermore, the definition of allergic reactions to food depends very much on the experience and opinion of the individual clinician, and this considerably influences the reported incidence and type of symptoms. Since no study on this subject has been conducted in the Federal Republic of Germany, we must rely on studies in neighbouring countries, such as those of Jacobsson and Lindberg in Malmö [1]. In a careful prospective study based on the results of well-defined elimination/challenge procedures, they reported a frequency of 1.9% in the 1st year of life. The most frequent combinations of symptoms were gastrointestinal and skin. Two-thirds of symptomatic infants showed gastrointestinal symptoms, such as colic, vomiting and diarrhoea. The main antigen was cow’s milk protein, followed by soya, egg, fish, organges, tomatoes and cereals. Among the 20 allergic patients only two showed failure to thrive, indicating malabsorption following damage to the small-intestinal mucosa.

Keywords

Zinc Catheter Superoxide Cystein Explosive 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Jakobsson J, Lindberg T (1979) A prospective study of cow’s milk protein intolerance in Swedish infants. Acta Paediatr Scand 68:853–859PubMedCrossRefGoogle Scholar
  2. 2.
    Maluenda C, Phillips AD, Briddon A, Walker-Smith JA (1984) Quantitative analysis of small intestinal mucosa in cow’s milk sensitive enteropathy. J Ped Gastr Nutr 3:349–356CrossRefGoogle Scholar
  3. 3.
    Iyngkaran N, Robinson M, Prathap K et al. (1978) Cow’s milk protein-sensitive enteropathy. Combined clinical and histological criteria for diagnosis. Arch Dis Child 53:20–26PubMedCrossRefGoogle Scholar
  4. 4.
    Walker-Smith J (1982) Cow’s milk intolerance as a cause of postenteritis diarrhoea. J Pediatr Gastroenterol Nutr 1:163–173PubMedCrossRefGoogle Scholar
  5. 5.
    Morin CL, Weber A, Buts JP et al. (1979) One-hour blood-xylose test in diagnosis of cow’s milk protein intolerance. Lancet I:1102–1104CrossRefGoogle Scholar
  6. 6.
    Iyngkaran N, Abidin Z (1982) One-hour blood xylose in the diagnosis of cow’s milk protein sensitive enteropathy. Arch Dis Child 57:40–43PubMedGoogle Scholar
  7. 7.
    Bürgin-Wolff A, Signer E, Friess HM et al. (1980) The diagnostic significance of antibodies in various cow’s milk proteins (fluorescent immunosorbent test). Eur J Pediatr 133:17–24PubMedCrossRefGoogle Scholar
  8. 8.
    Stern M, Stupp W, Grüttner R (1982) Cow’s milk protein antibodies determined by immunofluorescence (RIFT) in cow’s milk protein intolerance and in controls. Monatsschr Kinderheilkd 130:556–561PubMedGoogle Scholar
  9. 9.
    Savilahti E (1973) Immunochemical study of the malabsorption syndrome with cow’s milk intolerance. Gut 14:491–501PubMedCrossRefGoogle Scholar
  10. 10.
    Pearson JR, Kingston D, Shiner M (1983) Antibody production to milk protein in the jejunal mucosa of children with cow’s milk protein intolerance. Pediatr Res 17:406–412PubMedCrossRefGoogle Scholar
  11. 11.
    Stern M, Dietrich R, Mueller J (1982) Small intestinal mucosa ion coeliac disease and cow’s milk protein intolerance: morphometric and immunofluorescent studies. Eur J Pediatr 139:101–105PubMedCrossRefGoogle Scholar
  12. 12.
    Shiner M (1981) Ultrastructural features of allergic manifestations in the small intestine of children. Scand J Gastroenterol (Suppl), 70:49–64Google Scholar
  13. 13.
    Savilahti E, Kuitunen P, Visakorpi JK (1981) Cow’s milk allergy. In: Lebenthal E (ed) Textbook of gastroenterology and nutrition in infancy, vol 2. New York, Ravens, New York, pp 689–708Google Scholar
  14. 14.
    Shah PG, Freier S, Park BH et al. (1982) Pancreozymin and secretin enhance duodenal fluid antibody levels to cow’s milk proteins. Gastroenterology 83:916–921PubMedGoogle Scholar
  15. 15.
    Kosnai I, Kuitunen P, Savilahti E et al. (1980) Cell kinetics in the jejunal crypt epithelium in malabsorption syndrome with cow’s milk protein intolerance and in coeliac disease. Gut 21:1041–1046PubMedCrossRefGoogle Scholar
  16. 16.
    Phillips AD, Rice SJ, France NE et al. (1979) Small intestine intraepithelial lympohocyte levels in cow’s milk protein intolerance. Gut 20:509–512PubMedCrossRefGoogle Scholar
  17. 17.
    Harrison M, Kilby A, Walker-Smith JA et al. (1976) Cow’s milk protein intolerance: a possible association with gastroenteritis, lactose intolerance, and IgA deficiency. Br Med J I:1501–1504CrossRefGoogle Scholar
  18. 18.
    Porter P (1979) Adoptive immunization by the neonate by breast factors. In: Ogra PL, Dayton D (eds) Immunology of breast milk. Ravens, New York, pp 197–206Google Scholar
  19. 19.
    Ament ME, Rubin CE (1972) Soy-protein — another cause of the flat intestinal lesion. Gastroenterology 62:227–234PubMedGoogle Scholar
  20. 20.
    Perkkio M, Savilahti E, Kuitunen P (1981) Morphometric and immunohistochemical study of jejunal biopsies from children with intestinal soy allergy. Eur J Pediatr 137:63–69PubMedCrossRefGoogle Scholar
  21. 21.
    Greene HL, McCabe DR, Merenstein G (1975) Protacted diarrhea and malnutrition in infancy: changes in intestinal morphology and disaccharidase activities during treatment with total intravenous nutrition or oral elemental diets. J Pediatr 87:695–704PubMedCrossRefGoogle Scholar
  22. 22.
    Weizman Z, Schmueli A, Deckelbaum RJ (1983) Continuous nasogastric drip elemental feeding. Am J Dis Child 137:253–255PubMedGoogle Scholar
  23. 23.
    Anonymus (1987) Chronic diarrhoea in children — a nutritional disease (Editorial). Lancet I:143–144Google Scholar
  24. 24.
    Harms HK, Bertele RM (1983) Die schwere protrahierte Säuglingsdiarrhoe (“intractable diarrhoea”). Monatsschr Kinderheilkd 131:428–435PubMedGoogle Scholar
  25. 25.
    MacFarlane PJ, Miller V (1984) Human milk in the management of protracted diarrhoea of infancy. Arch Dis Child 59:260–265PubMedCrossRefGoogle Scholar
  26. 26.
    Kuitunen P, Visakorpi HK, Savilahti E, Pelkonen P (1975) Malabsorption syndrome with cow’s milk intolerance. Arch Dis Child 50:351–356PubMedCrossRefGoogle Scholar
  27. 27.
    Goldman AS, Thorpe LW, Goldblum RM, Hanson LA (1986) Anti-inflammatory properties of human milk. Acta Paediatr Scand 75:689–695PubMedCrossRefGoogle Scholar
  28. 28.
    Vitoria JC, Camarero C, Sojo A et al. (1986) Enteropathy related to fish, rice, and chicken. Arch Dis Child 57:44–48Google Scholar
  29. 29.
    Lake AM, Whitington PF, Hamilton SR (1982) Dietary protein-induced colitis in breast-fed infants. J Pediatr 101:906–910PubMedCrossRefGoogle Scholar
  30. 30.
    Jenkins HR, Pincott JR, Soothill HF et al. (1984) Food allergy: the major cause of infantile colitis. Arch Dis Child 59:326–329PubMedCrossRefGoogle Scholar
  31. 31.
    Shorter RG (1987) Idiopathic inflammatory bowel disease: a form of food allergy? In: Brostoff J, Challcombe SJ (eds) Food allergy and intolerance. Bailliere, Tindall, London, pp 549–554Google Scholar
  32. 32.
    Jakobsson J, Lindberg T (1978) Cow’s milk as a cause of infantile colic in breastfed infants. Lancet 2:437–439PubMedCrossRefGoogle Scholar
  33. 33.
    Jakobsson J, Lindberg T (1983) Cow’s milk proteins cause infantile colic in breast-fed infants: a double-blind cross over study. Pediatrics 71:268–271PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • H. K. Harms
  • R. M. Bertele-Harms

There are no affiliations available

Personalised recommendations