Prospective Assessment of Pediatrician-Diagnosed Food Protein–Induced Allergic Proctocolitis by Gross or Occult Blood
| Autor: | Kuan Wen Su, Corinne A. Keet, Yamini V. Virkud, Renata Ndahayo, Brinda Gupta, Eileen Kramer, Alanna Hickey, Tetiana Pronchick, Susan Reuter, Qian Yuan, Victoria M. Martin, Caroline Southwick, Hannah L. Seay, Michael Elkort, Wayne G. Shreffler, Rachael Rosow |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Population Breast milk Proctocolitis Lower risk 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Animals Humans Immunology and Allergy Cumulative incidence Pediatricians Prospective Studies 030212 general & internal medicine Child education education.field_of_study business.industry Incidence (epidemiology) Hazard ratio Infant Newborn Infant Odds ratio Confidence interval 030228 respiratory system Occult Blood Female Milk Hypersensitivity business Food Hypersensitivity |
| Zdroj: | The Journal of Allergy and Clinical Immunology: In Practice. 8:1692-1699.e1 |
| ISSN: | 2213-2198 |
| Popis: | Background Food protein–induced allergic proctocolitis (FPIAP) is an early and common manifestation of food allergy, yet its epidemiology and relationship to other allergic diseases remain unclear. Objective To prospectively define the incidence of FPIAP as it is being diagnosed clinically in the community and to identify factors associated with its development. Methods A total of 1003 of 1162 eligible serial healthy newborn infants recruited from a single suburban pediatrics practice were followed prospectively for the diagnosis of FPIAP. Investigators reviewed each case to confirm prespecified inclusion criteria, including documented gross or occult blood in the stool. Results A total of 903 infants were analyzed (46% females, 89% term, 32% caesarian-section, 9% neonatal antibiotics); 153 cases met inclusion criteria, a cumulative incidence of 17%, while 63 (7%) had gross blood. Infants initially fed both breast milk and formula were 61% less likely to develop FPIAP compared with those exclusively formula-fed (hazard ratio, 0.39; P = .005). Breast milk and formula at any point during the first 4 months were also associated with lower risk compared with exclusive formula or exclusive breast milk (hazard ratio, 0.44; P = .005; hazard ratio, 0.62; P = .0497). Eczema (odds ratio, 1.5; 95% confidence interval, 1.1- 2.2; P = .02) or a first-degree relative with food allergies (odds ratio, 1.9; 95% confidence interval, 1.2-2.8; P = .005) were among risk factors for FPIAP development. Conclusions The prospectively defined incidence of FPIAP when diagnosed clinically by community pediatricians without challenge is markedly higher than published estimates. Combination feeding of formula and breast milk is associated with the lowest rate of FPIAP in this population. |
| Databáze: | OpenAIRE |
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