Öz
Objective: The incidence of allergic proctocolitis due to food protein is increasing. Therefore, studies are needed to elucidate the pathophysiology of the disease as well as to identify simple, non-invasive markers. The aim of this study was to evaluate the relationship between the level of eosinophil in the blood and allergic proctocolitis.
Materials and Methods: The files of patients who were diagnosed with allergic proctocolitis at the Pediatric Allergy Outpatient Clinic of Başkent University’s Faculty of Medicine, Ankara Hospital, between 2011 and 2021 were retrospectively reviewed. Three groups were formed according to eosinophil counts. Those with an eosinophil count below 400 10³/µL were considered as the normal eosinophil group, those whose count was between 400-1499 10³/µL were considered as the eosinophilia group, and those with 1500 10³/µL and above were considered as the hypereosinophilia group.
Results: There were 108 patients diagnosed with allergic proctocolitis, of which 49.1% (n:53) were male. Of all the patients, 14.8% (n: 16) were in the hypereosinophilia group and 29.6% (n: 32) were in the eosinophilia group. Eosinophil elevation was more common in boys. There was no statistically significant difference in eosinophil count between those with single and multiple food allergies. It was observed that multiple food allergies were more common in babies older than two months (n:76) than in babies aged two months and younger (n:32) (p=0.031).
Conclusion: In our study, there was no difference between eosinophil levels and symptoms in infants with allergic proctocolitis. However, the importance of investigating multiple food allergies in the presence of eosinophilia in infants older than two months is clear.
Anahtar Kelimeler
Proje Numarası
KA16/66
Kaynakça
- Cetinkaya PG, Ocak M, Sahiner UM, Sekerel BE, Soyer O. Food protein-induced allergic proctocolitis may have distinct phenotype. Ann Allergy Asthma Immunol. 2021;126:75-82. google scholar
- Koksal BT, Barıs Z, Ozcay F, Yilmaz-Ozbek O. Single and multiple food allergies in infants with proctocolitis. Allergol Immunopathol. 2018;46(1):3-8. google scholar
- ABM Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant. Breastfeedıng medıcıne 2011;6:6. google scholar
- Erdem SB, Nacaroglu HT, Karaman S, Erdur CB, Karkıner CU, Can D. Tolerance development in food protein-induced allergic proctocolitis: Single centre experience. Allergol Immunopathol. 2017;45(3):212-219. google scholar
- Man-Chun Y, Chia-Lun T, Yao-Jong Y, Sing-San Y, Li-Hui W, Chung-Ta L, et al. Allergic Colitis in Infants Related to Cow’s Milk: Clinical Characteristics, Pathologic Changes, and Immunologic Findings. Pediatr Neonatol 2013;54:49-55. google scholar
- Fiocchi A, Schünemann HJ, Brozek J, Restani P, Beyer K, Troncone R, et al. Diagnosis and Rationalefor Action Against Cow’s Milk Allergy (DRACMA): a summary report. J Allergy Clin Immunol. 2010;126(6):1119-1128. google scholar
- Çam S. The Prediction of Allergic Proctocolitis by Using Hematological Parameters. Duzce Med J, 2020;22:119-123 google scholar
- Costagliola G, Di Marco S, Comberiati P, D’Elios S, Petashvili N, Di Cicco ME, et al. Practical Approach to Children Presenting with Eosinophila and Hypereosinophilia.Review. Curr Pediatr Rev. 2020;16:81-88. doi: 10.2174/1573396315666191114150438. google scholar
- Shunji I, Yoshikazu K, Alain S. Eosinophilic Esophagitis, Eosinophilic Gastroenteritis, and Eosinophilic Colitis: Common Mechanisms and Differences between East and West. Inflamm Intest Dis 2016;1:63-69. google scholar
- Kinoshita Y, Furuta K, Ishimaura N, et al: Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis. J Gastroenterol 2013;48: 333-339. google scholar
- Lozinsky AC, Morais MB. Eosinophilic colitis in infants. J Pediatr. (Rio J) 2014;90:16-21. google scholar
- Kinoshita Y, Furuta K, Ishimura N, Ishihara S. Elevated plasma cytokines in Japanese patients with eosinophilic esophagitis and gastroenteritis. Digestion 2012;86:238-243 google scholar
- Kaya A, Toyran M, Civelek E, Misirlioglu E, Kirsaclioglu C, Kocabas CN. Characteristics and Prognosis of Allergic Proctocolitis in Infants JPGN 2015;61: 69-73. google scholar
- Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: epidemiology, clinical features, and current management. Reiew. Ther Adv Gastroenterol (2010) 4(5) 301-309. google scholar
- Galip N, Babayigit-Hocaoğlu A. Allergic Disorders of Gastrointestinal System. Review . Journal of Clinical Medicine Pediatrics 2017; 9: 2. google scholar
- Lake AM. Food-induced eosinophilic proctocolitis. J Pediatr Gastroenterol Nutr. 2000;30 Suppl:S58-60. google scholar
- Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriguez Z, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354:23-33. doi:10.1056/ NEJMoa052664. google scholar
- Karakaş NM, Arslan A, Atalay E, Ayli I, Bağcı ZI, Cesaretli S, et al. May rotavirus vaccine be affect food allergy prevalence? Human vaccınes & ımmunotherapeutıcs 2020;16:1952-1956. google scholar
- Dogru M, Evcimik MF, Cirik AA. Is neutrophillymphocyte ratio associated with the severity of allergic rhinitis in children? Eur Arch Otorhinolaryngol. 2016;273(10):3175-8. google scholar
- Dogru M, Yesiltepe-Mutlu RG. The evaluation of neutrophil-lymphocyte ratio in children with asthma. Allergol Immunopathol (Madr). 2016;44(4):292-6. google scholar
- Mennini M, Giovanni-Fiocchi M, Cafarotti A, Montesano M, Mauro A, Villa MP et al. Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol. Mennini et al. World Allergy Organization Journal (2020) 13:100471 google scholar
- Concha S, Cabalin C, Iturriaga C. Diagnostic validity of fecal occult blood test in infants with food protein-induced allergic proctocolitis. Rev Chil Pediatr. 2018;89(5):630-637. google scholar
Öz
Amaç: Besin proteinine bağlı alerjik proktokolit görülme sıklığı artmaktadır. Bu nedenle hastalığın patofizyolojisinin aydınlatılmasının yanı sıra basit, invaziv olmayan belirteçlerin belirlenmesine yönelik çalışmalara ihtiyaç duyulmaktadır. Çalışmamızın amacı eozinofil düzeyi ile alerjik proktokolit arasındaki ilişkiyi değerlendirmektir.
Gereç ve Yöntem: Başkent Üniversitesi Tıp Fakültesi, Ankara Hastanesi Çocuk Alerji polikliniğinde 2011-2021 yılları arasında alerjik proktokolit tanısı almış olan hastaların dosyaları retrospektif olarak incelendi. Eozinofil sayılarına göre üç grup oluşturuldu. Eozinofil düzeyi 400 10³/µL altında olanlar normal eozinofil grubu, 400-1499 10³/µL arası olanlar eozinofili grubu, 1500 10³/µL ve üzeri olanlar hipereozinofili grubu olarak değerlendirildi. Çalışma Başkent Üniversitesi yerel etik kurulu tarafından onaylanan protokole uygun olarak yapıldı.
Bulgular: Alerjik proktokolit tanısı almış 108 hastanın %49,1’i (n:53) erkekti. Median yaş 3,5 (0,5-10) aydı. Tüm hastaların %14,8’i (n:16) hipereozinofili, %29,6’sı (n:32) eozinofili grubundaydı. Eozinofil yüksekliği erkek çocuklarda daha fazla görüldü (eozinofili grubunun %71,9’u, hipereozinofili grubunun %50’si erkekti). Gruplar arasında sadece anne sütü alan ile anne sütü ve formula mama alan infantlar açısından bir farklılık yoktu. Atopik dermatit, eozinofili grubunun %9,4’ünde, hipereozinofili grubunun da %5,9’unda mevcuttu. Sadece 56 hastaya deri prik testi uygulanmıştı. Deri prik testi sonuçlarına göre gruplar arasında anlamlı bir farklılık saptanmadı. Tekli ve çoklu besin alerjisi olanlar arasında eozinofil sayısı açısından istatistiksel olarak anlamlı fark yoktu. İki ay üstü bebeklerde (n:76) çoklu besin alerjisinin iki ay ve altı bebeklere (n:32) göre daha sık olduğu görüldü (p=0,031).
Sonuç: Çalışmamızda, alerjik proktokolitli bebeklerde eozinofil düzeyleri ile semptomlar arasında bir farklılık görülmedi. Ancak iki ay üstü bebeklerde eozinofili varlığında çoklu besin alerjisinin araştırılmasının önemini belirtmektedir.
Anahtar Kelimeler
Destekleyen Kurum
Baskent Univesity, Ankara Baskent Hospital
Proje Numarası
KA16/66
Teşekkür
-
Kaynakça
- Cetinkaya PG, Ocak M, Sahiner UM, Sekerel BE, Soyer O. Food protein-induced allergic proctocolitis may have distinct phenotype. Ann Allergy Asthma Immunol. 2021;126:75-82. google scholar
- Koksal BT, Barıs Z, Ozcay F, Yilmaz-Ozbek O. Single and multiple food allergies in infants with proctocolitis. Allergol Immunopathol. 2018;46(1):3-8. google scholar
- ABM Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant. Breastfeedıng medıcıne 2011;6:6. google scholar
- Erdem SB, Nacaroglu HT, Karaman S, Erdur CB, Karkıner CU, Can D. Tolerance development in food protein-induced allergic proctocolitis: Single centre experience. Allergol Immunopathol. 2017;45(3):212-219. google scholar
- Man-Chun Y, Chia-Lun T, Yao-Jong Y, Sing-San Y, Li-Hui W, Chung-Ta L, et al. Allergic Colitis in Infants Related to Cow’s Milk: Clinical Characteristics, Pathologic Changes, and Immunologic Findings. Pediatr Neonatol 2013;54:49-55. google scholar
- Fiocchi A, Schünemann HJ, Brozek J, Restani P, Beyer K, Troncone R, et al. Diagnosis and Rationalefor Action Against Cow’s Milk Allergy (DRACMA): a summary report. J Allergy Clin Immunol. 2010;126(6):1119-1128. google scholar
- Çam S. The Prediction of Allergic Proctocolitis by Using Hematological Parameters. Duzce Med J, 2020;22:119-123 google scholar
- Costagliola G, Di Marco S, Comberiati P, D’Elios S, Petashvili N, Di Cicco ME, et al. Practical Approach to Children Presenting with Eosinophila and Hypereosinophilia.Review. Curr Pediatr Rev. 2020;16:81-88. doi: 10.2174/1573396315666191114150438. google scholar
- Shunji I, Yoshikazu K, Alain S. Eosinophilic Esophagitis, Eosinophilic Gastroenteritis, and Eosinophilic Colitis: Common Mechanisms and Differences between East and West. Inflamm Intest Dis 2016;1:63-69. google scholar
- Kinoshita Y, Furuta K, Ishimaura N, et al: Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis. J Gastroenterol 2013;48: 333-339. google scholar
- Lozinsky AC, Morais MB. Eosinophilic colitis in infants. J Pediatr. (Rio J) 2014;90:16-21. google scholar
- Kinoshita Y, Furuta K, Ishimura N, Ishihara S. Elevated plasma cytokines in Japanese patients with eosinophilic esophagitis and gastroenteritis. Digestion 2012;86:238-243 google scholar
- Kaya A, Toyran M, Civelek E, Misirlioglu E, Kirsaclioglu C, Kocabas CN. Characteristics and Prognosis of Allergic Proctocolitis in Infants JPGN 2015;61: 69-73. google scholar
- Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: epidemiology, clinical features, and current management. Reiew. Ther Adv Gastroenterol (2010) 4(5) 301-309. google scholar
- Galip N, Babayigit-Hocaoğlu A. Allergic Disorders of Gastrointestinal System. Review . Journal of Clinical Medicine Pediatrics 2017; 9: 2. google scholar
- Lake AM. Food-induced eosinophilic proctocolitis. J Pediatr Gastroenterol Nutr. 2000;30 Suppl:S58-60. google scholar
- Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriguez Z, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354:23-33. doi:10.1056/ NEJMoa052664. google scholar
- Karakaş NM, Arslan A, Atalay E, Ayli I, Bağcı ZI, Cesaretli S, et al. May rotavirus vaccine be affect food allergy prevalence? Human vaccınes & ımmunotherapeutıcs 2020;16:1952-1956. google scholar
- Dogru M, Evcimik MF, Cirik AA. Is neutrophillymphocyte ratio associated with the severity of allergic rhinitis in children? Eur Arch Otorhinolaryngol. 2016;273(10):3175-8. google scholar
- Dogru M, Yesiltepe-Mutlu RG. The evaluation of neutrophil-lymphocyte ratio in children with asthma. Allergol Immunopathol (Madr). 2016;44(4):292-6. google scholar
- Mennini M, Giovanni-Fiocchi M, Cafarotti A, Montesano M, Mauro A, Villa MP et al. Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol. Mennini et al. World Allergy Organization Journal (2020) 13:100471 google scholar
- Concha S, Cabalin C, Iturriaga C. Diagnostic validity of fecal occult blood test in infants with food protein-induced allergic proctocolitis. Rev Chil Pediatr. 2018;89(5):630-637. google scholar
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Çocuk Sağlığı ve Hastalıkları |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | KA16/66 |
| Yayımlanma Tarihi | 24 Ekim 2023 |
| Yayımlandığı Sayı | Yıl 2023 |