Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2025
Long-term risk of allergic diseases after allergic proctocolitis: A clinical perspective.
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Kazancioglu Alp, Ozdemiral Cansu, Gur Cetinkaya Pinar, Ocak Melike, Sahiner Umit Murat, Sekerel Bulent Enis, Soyer Ozge
Аннотация
BACKGROUND: The long-term progression of allergic conditions in children with a history of food protein-induced allergic proctocolitis (FPIAP) remains unclear.
OBJECTIVE: To assess the prevalence and clinical characteristics of allergic diseases, particularly asthma, in patients with a history of FPIAP.
METHODS: In this retrospective case-control study, we included 170 patients diagnosed with having FPIAP (median age [IQR]: 7.4 [6.9-8.0] years) who developed tolerance at a median age of 12 months (IQR: 10.0-14.0). Control groups comprised patients with non-food allergy (non-FA; n = 101), outgrown IgE-mediated cow's milk allergy (IgE-CMA; n = 97), and current IgE-CMA (n = 100). The proportions of asthma and allergic rhinitis (AR) were compared among the groups.
RESULTS: The FPIAP group exhibited a higher risk of developing asthma and AR than the non-FA group did (asthma: adjusted odds ratio: 4.273, 95% CI: 2.173-8.403, P < .001; AR: adjusted odds ratio: 3.039, 95% CI: 1.199-7.692, P = .019). The proportions of asthma and AR in the FPIAP group (45.2% and 17.6%, respectively) were significantly higher than those in the non-FA group (12.9%, P < .001; 5.9%, P = .006) but lower than those in the current IgE-CMA group (74%, P < .001; 36%, P = .001). No significant differences were observed between the FPIAP and outgrown IgE-CMA groups. However, patients with FPIAP exhibited poorer asthma control than those in the IgE-mediated CMA groups did.
CONCLUSION: Children with a history of FPIAP are at an increased risk of developing asthma and AR, necessitating ongoing monitoring. Further research is needed to clarify the role of FPIAP in the allergic march.
OBJECTIVE: To assess the prevalence and clinical characteristics of allergic diseases, particularly asthma, in patients with a history of FPIAP.
METHODS: In this retrospective case-control study, we included 170 patients diagnosed with having FPIAP (median age [IQR]: 7.4 [6.9-8.0] years) who developed tolerance at a median age of 12 months (IQR: 10.0-14.0). Control groups comprised patients with non-food allergy (non-FA; n = 101), outgrown IgE-mediated cow's milk allergy (IgE-CMA; n = 97), and current IgE-CMA (n = 100). The proportions of asthma and allergic rhinitis (AR) were compared among the groups.
RESULTS: The FPIAP group exhibited a higher risk of developing asthma and AR than the non-FA group did (asthma: adjusted odds ratio: 4.273, 95% CI: 2.173-8.403, P < .001; AR: adjusted odds ratio: 3.039, 95% CI: 1.199-7.692, P = .019). The proportions of asthma and AR in the FPIAP group (45.2% and 17.6%, respectively) were significantly higher than those in the non-FA group (12.9%, P < .001; 5.9%, P = .006) but lower than those in the current IgE-CMA group (74%, P < .001; 36%, P = .001). No significant differences were observed between the FPIAP and outgrown IgE-CMA groups. However, patients with FPIAP exhibited poorer asthma control than those in the IgE-mediated CMA groups did.
CONCLUSION: Children with a history of FPIAP are at an increased risk of developing asthma and AR, necessitating ongoing monitoring. Further research is needed to clarify the role of FPIAP in the allergic march.