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allergy enteropathy

Anna Nowak-Wegrzyn, Hania Szajewska, Gideon Lack
Food allergy develops as a consequence of a failure in oral tolerance, which is a default immune response by the gut-associated lymphoid tissues to ingested antigens that is modified by the gut microbiota. Food allergy is classified on the basis of the involvement of IgE antibodies in allergic pathophysiology, either as classic IgE, mixed pathophysiology or non-IgE-mediated food allergy. Gastrointestinal manifestations of food allergy include emesis, nausea, diarrhoea, abdominal pain, dysphagia, food impaction, protein-losing enteropathy and failure to thrive...
December 21, 2016: Nature Reviews. Gastroenterology & Hepatology
Aydan Kansu, Aysel Yüce, Buket Dalgıç, Bülent Enis Şekerel, Fügen Çullu-Çokuğraş, Haluk Çokuğraş
The present paper aims to provide experts' consensus on diagnosis and management of cow's milk protein allergy (CMPA) among infants and children in Turkey, based on review of available evidence-based guidelines, publications and experts' clinical experience. The experts agreed that CMPA diagnosis should be based on symptomatic evaluation and diagnostic elimination diet as followed by implementation of an open challenge test after disappearance of symptoms and confirmation of CMPA diagnosis in re-appearance of symptoms...
2016: Turkish Journal of Pediatrics
Jean-Christoph Caubet, Hania Szajewska, Raanan Shamir, Anna Nowak-Węgrzyn
Non-IgE-mediated gastrointestinal food allergic disorders (non-IgE-GI-FA) including food protein-induced enterocolitis syndrome (FPIES), food protein-induced enteropathy (FPE), and food protein-induced allergic proctocolitis (FPIAP) are relatively uncommon in infants and young children, but are likely under-diagnosed. Non-IgE-GI-FA have a favorable prognosis, with majority resolving by age 3-5 years. Diagnosis relies on the recognition of symptoms pattern in FPIAP and FPIES and biopsy in FPE. Further studies are needed for a better understanding of the pathomechanism, which will lead eventually to the development of diagnostic tests and treatments...
February 2017: Pediatric Allergy and Immunology
Melanie Uhde, Mary Ajamian, Giacomo Caio, Roberto De Giorgio, Alyssa Indart, Peter H Green, Elizabeth C Verna, Umberto Volta, Armin Alaedini
OBJECTIVE: Wheat gluten and related proteins can trigger an autoimmune enteropathy, known as coeliac disease, in people with genetic susceptibility. However, some individuals experience a range of symptoms in response to wheat ingestion, without the characteristic serological or histological evidence of coeliac disease. The aetiology and mechanism of these symptoms are unknown, and no biomarkers have been identified. We aimed to determine if sensitivity to wheat in the absence of coeliac disease is associated with systemic immune activation that may be linked to an enteropathy...
December 2016: Gut
Behdad Navabi, Julia Elizabeth Mainwaring Upton
BACKGROUND: Eosinophilia is not an uncommon clinical finding. However, diagnosis of its cause can be a dilemma once common culprits, namely infection, allergy and reactive causes are excluded. Primary immunodeficiency disorders (PID) are among known differentials of eosinophilia. However, the list of PIDs typically reported with eosinophilia is small and the literature lacks an inclusive list of PIDs which have been reported with eosinophilia. This motivated us to review the literature for all PIDs which have been described to have elevated eosinophils as this may contribute to an earlier diagnosis of PID and further the understanding of eosinophilia...
2016: Allergy, Asthma, and Clinical Immunology
Ryuzo Higuchi, Mina Booka, Hiroyuki Suzuki, Hiroshi Tsuno
A 4-month-old breast-fed girl presented with poor weight gain, and had edema and repeated erythema from 5 months of age. The diagnosis of protein-losing enteropathy (PLE) was confirmed on (99m) Tc-labeled human serum albumin scintigraphy. Specific IgE radioallergosorbent test was class 3 for egg white, class 2 for egg yolk, and negative for other foods. Elimination of egg from the mother's diet and oral epinastine hydrochloride treatment and sodium cromolyn improved hypoalbuminemia, hypogammaglobulinemia, and erythema...
January 28, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Saba Arshi, Mohammad Nabavi, Mohammad Hasan Bemanian, Ramin Shakeri, Behrang Taghvaei, Babak Ghalebaghi, Delara Babaie, Ahmad Bahrami, Morteza Fallahpour, Hossein Esmaeilzadeh, Mahsa Rekabi, Javad Amadian, Narjes Eslami, Sima Shokri, Farhad Jalali, Nadieh Akbarpour, Rasol Molatefi, Nima Rezaei
BACKGROUND: Common variable immune deficiency (CVID) is a heterogeneous syndrome with a wide variety of signs and symptoms. This study describes the phenotyping and survival of the CVID patients in the allergy and clinical immunology department of Rasol-E-Akram Hospital of Iran University of Medical Sciences in Tehran. METHOD: We retrospectively reviewed hospital files of CVID patients in our department until January 2014. All patients were diagnosed with standard diagnostic criteria of CVID, treated and visited monthly, during the follow-up period...
May 2016: Allergologia et Immunopathologia
Kelli W Williams, Joshua D Milner, Alexandra F Freeman
Increased serum eosinophil levels have been associated with multiple disorders of immune deficiency or immune dysregulation. Although primary immunodeficiency diseases are rare, it is important to consider these in the differential diagnosis of patients with eosinophilia. In this review, the clinical features, laboratory findings, diagnosis, and genetic basis of disease of several disorders of immune deficiency or dysregulation are discussed. The article includes autosomal dominant hyper IgE syndrome, DOCK8 deficiency, phosphoglucomutase 3 deficiency, ADA-SCID, Omenn syndrome, Wiskott-Aldrich syndrome, Loeys-Dietz syndrome, autoimmune lymphoproliferative syndrome, immunodysregulation, polyendocrinopathy, enteropathy, X-linked syndrome, Comel-Netherton syndrome, and severe dermatitis, multiple allergies, and metabolic wasting syndrome...
August 2015: Immunology and Allergy Clinics of North America
Markus Hahn, Alexander F Hagel, Simon Hirschmann, Caroline Bechthold, Peter Konturek, Markus Neurath, Martin Raithel
At an incidence of 1:500, celiac disease (formerly sprue) is an important differential diagnosis in patients with malabsorption, abdominal discomfort, diarrhea and food intolerances. Celiac disease can induce a broad spectrum of both gastrointestinal and extraintestinal symptoms, e.g. dermatitis herpetiformis (Duhring's disease). A variety of oligo- and asymptomatic courses (e.g. anemia, osteoporosis, depression) through to refractory collagenic celiac disease are seen. In HLA-DQ2 and -8 predisposed individuals, celiac disease is provoked by contact with wheat gliadin fractions through a predominantly Th1 immune response and an accompanying Th2 response, which can eventually lead to villous atrophy...
2014: Allergo Journal International
J Lemale, L Dainese, P Tounian
Eosinophilic gastrointestinal disorders are a heterogeneous group of disorders characterized by no specific digestive symptoms associated with dense eosinophilic inflammation of the gastrointestinal tract in the absence of known causes for such tissue eosinophilia. Among these diseases, eosinophilic gastroenteritis (EGE) and colitis (EC) are less common than esophagitis, but their incidence and prevalence have been increasing over the past decade due in part to increased disease recognition. The exact pathophysiology is not clear: EGE and EC are immune-mediated diseases implicating adaptive T-helper cell type 2 immunity...
July 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ian S Brown, Andrew Bettington, Mark Bettington, Christophe Rosty
AIMS: To describe the clinical and pathological features of a series of patients with biopsy findings of a coeliac disease-like enteropathy in the setting of an acute illness. METHODS AND RESULTS: Eighteen cases of an abrupt-onset, self-limited illness with coeliac-like enteropathy (SLCE) were collected prospectively. Medication reaction, immune disorder, food allergy and parasitic infection were excluded. Coeliac disease was excluded by the transient nature of the illness and absence of tissue transglutaminase (TTG) elevation (nine of nine) or human leucocyte antigen (HLA)-DQ2/DQ8 haplotype (eight of nine)...
January 2016: Histopathology
Ralf G Heine
Gastrointestinal food allergies present during early childhood with a diverse range of symptoms. Cow's milk, soy and wheat are the three most common gastrointestinal food allergens. Several clinical syndromes have been described, including food protein-induced enteropathy, proctocolitis and enterocolitis. In contrast with immediate, IgE-mediated food allergies, the onset of gastrointestinal symptoms is delayed for at least 1-2 hours after ingestion in non-IgE-mediated allergic disorders. The pathophysiology of these non-IgE-mediated allergic disorders is poorly understood, and useful in vitro markers are lacking...
2015: Chemical Immunology and Allergy
Anna Nowak-Węgrzyn, Yitzhak Katz, Sam Soheil Mehr, Sibylle Koletzko
Non-IgE-mediated gastrointestinal food-induced allergic disorders (non-IgE-GI-FAs) account for an unknown proportion of food allergies and include food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). Non-IgE-GI-FAs are separate clinical entities but have many overlapping clinical and histologic features among themselves and with eosinophilic gastroenteropathies. Over the past decade, FPIES has emerged as the most actively studied non-IgE-GI-FA, potentially because of acute and distinct clinical features...
May 2015: Journal of Allergy and Clinical Immunology
Kurt R Schumacher, Kathleen A Stringer, Janet E Donohue, Sunkyung Yu, Ashley Shaver, Regine L Caruthers, Brian J Zikmund-Fisher, Carlen Fifer, Caren Goldberg, Mark W Russell
OBJECTIVE: To characterize the medical history, disease progression, and treatment of current-era patients with the rare diseases Fontan-associated protein-losing enteropathy (PLE) and plastic bronchitis. STUDY DESIGN: A novel survey that queried demographics, medical details, and treatment information was piloted and placed online via a Facebook portal, allowing social media to power the study. Participation regardless of PLE or plastic bronchitis diagnosis was allowed...
April 2015: Journal of Pediatrics
Haruyo Nakajima-Adachi, Akira Kikuchi, Yoko Fujimura, Kyoko Shibahara, Tsuyoshi Makino, Masae Goseki-Sone, Miran Kihara-Fujioka, Tomonori Nochi, Yosuke Kurashima, Osamu Igarashi, Masafumi Yamamoto, Jun Kunisawa, Masako Toda, Shuichi Kaminogawa, Ryuichiro Sato, Hiroshi Kiyono, Satoshi Hachimura
BACKGROUND AND OBJECTIVE: To improve the efficacy and safety of tolerance induction for food allergies, identifying the tissues responsible for inducing intestinal inflammation and subsequent oral tolerance is important. We used OVA23-3 mice, which express an ovalbumin-specific T-cell receptor, to elucidate the roles of local and systemic immune tissues in intestinal inflammation. METHODS AND RESULTS: OVA23-3 mice developed marked enteropathy after consuming a diet containing egg white (EW diet) for 10 days but overcame the enteropathy (despite continued moderate inflammation) after receiving EW diet for a total of 28 days...
2014: PloS One
Sophia S Wang, Christopher R Flowers, Marshall E Kadin, Ellen T Chang, Ann Maree Hughes, Stephen M Ansell, Andrew L Feldman, Tracy Lightfoot, Paolo Boffetta, Mads Melbye, Qing Lan, Joshua N Sampson, Lindsay M Morton, Yawei Zhang, Dennis D Weisenburger
BACKGROUND: Accounting for 10%-15% of all non-Hodgkin lymphomas in Western populations, peripheral T-cell lymphomas (PTCL) are the most common T-cell lymphoma but little is known about their etiology. Our aim was to identify etiologic risk factors for PTCL overall, and for specific PTCL subtypes, by analyzing data from 15 epidemiologic studies participating in the InterLymph Consortium. METHODS: A pooled analysis of individual-level data for 584 histologically confirmed PTCL cases and 15912 controls from 15 case-control studies conducted in Europe, North America, and Australia was undertaken...
August 2014: Journal of the National Cancer Institute. Monographs
Huaibin M Ko, Raffaella A Morotti, Oksana Yershov, Mirna Chehade
OBJECTIVES: Eosinophilic gastritis (EG), defined by histological criteria as marked eosinophilia in the stomach, is rare, and large studies in children are lacking. We sought to describe the clinical, endoscopic, and histopathological features of EG, assess for any concurrent eosinophilia at other sites of the gastrointestinal (GI) tract, and evaluate response to dietary and pharmacological therapies. METHODS: Pathology files at our medical center were searched for histological eosinophilic gastritis (HEG) with ≥70 gastric eosinophils per high-power field in children from 2005 to 2011...
August 2014: American Journal of Gastroenterology
Christophe Dupont
Cow's milk protein allergy (CMPA) affect many organs, from mouth to gut, with, immediate and delayed reactions, including infantile colic, food protein induced enterocolitis syndrome, enteropathy, eosinophilic disorders, among which infantile proctocolitis, and "dysmotility" disturbances, gastro-esophageal reflux and constipation. Diagnosis follows usual steps, careful history taking and medical examination, before starting an elimination diet, for diagnosis and treatment. Beyond, laboratory tests may help, but definitive conclusion will arise from the oral food challenge...
February 2014: Expert Review of Clinical Immunology
K R Kamath
The epithelium of the gastrointestinal tract is constantly exposed to varieties of antigens. In healthy individuals, only small amounts of ingested dietary antigens are absorbed. The normal immune response to absorbed food antigens is one of tolerance, which enables food to play its nutritive ("food") role without causing disease. Breakdown in tolerance may result in a spectrum of clinical problems, including food allergy, food sensitive enteropathy and food intolerance ("fire"). When food-sensitive enteropathy is subclinical, continued ingestion of the offending food antigen sometimes results in development of tolerance and resolution of the enteropathy...
December 1995: Asia Pacific Journal of Clinical Nutrition
S K Lin, J R Lambert, M L Wahlqvist
The gastrointestinal tract, including the liver and pancreas, is a complex system whose function is to process a wide range of nutrient and other products enabling their absorption as well as detoxification and excretion. During the process, food is converted into energy and into other substances that are used by cells throughout the entire body. Many diseases can affect the various organs of the gastrointestinal (GI) system and diet plays a relatively minor role in the onset of such GI diseases. Recently it has become clear that glutamine, a 'non-essential' amino acid, is important in the maintenance of intestinal mucosal metabolism, structure and function...
March 1992: Asia Pacific Journal of Clinical Nutrition
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