Besin alerjili çocuk hastaların klinik ve laboratuvar özelliklerinin retrospektif olarak değerlendirilmesi
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2010
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Selçuk Üniversitesi Tıp Fakültesi
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Abstract
Bu çalışmada bölgemizde besin alerjisi tanısı konulan olguların klinik ve laboratuvar özelliklerinin değerlendirilmesi amaçlanmıştır. Bu çalışmada kasım 2007 ile aralık 2009 yılları arasında Çocuk Gastroenteroloji polikliniğine gastrointestinal şikayetlerle başvuran ve besin alerjisi tespit edilen olguların dosyaları geriye dönük olarak değerlendirildi. Besin spesifik IgE pozitifliği veya deri testi pozitifliği olan veya bunlar negatif olduğu halde şüpheli besinin eliminasyonu ile şikayetleri kaybolan olgulara besin alerjisi tanısı konuldu. Olgular yaş grubuna göre 1 yaş altı ve 1 yaş üstü olarak 2 gruba ayrıldı. Çalışmaya toplam 63 olgu alındı. Kız-erkek oranı eşitti. Olguların %39.6 sı 1 yaş üstünde, %60.4 ü 1 yaş altındaydı. Median takip süresi 10.5 ay (4-28 ay) ve median diyet süresi 8 ay (4-24 ay) idi. En sık başvuru nedeni proktokolit (kanlı ve/veya mukuslu ishal): % 33 ve gastroözofageal reflü belirtileri: % 28 idi. Olguların % 39.6 sında ailede atopi mevcuttu. Tüm olguların % 65 inde alerji testleri pozitifti. Bir yaş üstünde olguların % 84.2 sinin, 1 yaş altında ise % 36 sının spesifik IgE si pozitifti. Olguların % 65 inde inek sütü, % 19 unda yumurta, % 7.9 unda fıstık, % 7.9 unda çoklu alerjen duyarlılığı vardı. Spesifik IgE pozitifliği proktokolitli olgularda GÖR ve enterit bulguları ile başvuranlara göre anlamlı düşük idi (p<0.05). Proktokolitli olguların % 81 inden sorumlu besin inek sütü idi. Proktokolit bulguları ile başvuran ve inek sütü protein alerjisi tanısı konulan 7 olgu defalarca amip tedavisi almıştı. Özellikle 1 yaş altı çocuklarda gastrointestinal sistemin etkilendiği besin alerjilerinde anamnez ve klinik değerlendirme laboratuvardan daha değerlidir. Başka neden saptanamayan alt gastrointestinal kanamayla başvuran hastalarda alerji testleri negatif olsa da alerjik proktokolit akılda bulundurulmalıdır.
In this study, it was aimed to evaluate the features of clinical and laboratory of cases diagnosed as food allergies in our region. In this study, it was evaluated retrospectively files of cases who had gastrointestinal complaints and cases who detected food allergy and admitted Pediatric Gastroenterology clinic from November 2007 to December 2009. It was diagnosed as a food allergy them if cases who had a positive food specific IgE and/or a positive skin prick test, when these were negative, cases who lost their complaints by elimination of food suspecting. Patients were divided as children <1 year of age and those >1 year of age according to age groups. The study included 63 cases. Boy/ girl ratio was equal. 39,6 % of cases were >1 year of age group, 60,4 % of cases were <1 year of age group. The median period of follow-up was ten and a half months (range: 4-28 month) and the median period of dietary was eight months (range: 4-24 month). The most common reason for admission was proctocolitis (33 %) (bloody and/or mucus in diarrhoea) and ratio of symptoms of gastroeosaphageal reflu was 28 %. 39,6% of all cases had an atopic family history. 65 % of all cases had a positive skin prick test. 84,2 % of cases >1 year of age had a positive food specific IgE while 36 % of cases <1 year of age had a positive food specific IgE. The ratios of sensivity for cow’s milk, egg, peanut, multiple allergen were % 65, 8 % and % 8, respectively. Positivity of food specific IgE was significantly lower in cases with proctocolitis than those admitted with findings of GOR and enteritis (p<0.05). Cow’s milk was a responsible food for 81 % of cases with proctocolitis. Total seven cases admitted findings of proctocolitis and those diagnosed as cow’s milk protein allergy were repeatedly administered therapy for amebiasis. In case of food allergies affecting the gastrointestinal tract, the history and clinical evaluation are more valuable than the laboratory, especially in infants younger than 1 year of age. Allergic proctocolitis should be considered although allergy tests are negative, in patients admitted with lower gastrointestinal bleeding and those had no another detectable cause.
In this study, it was aimed to evaluate the features of clinical and laboratory of cases diagnosed as food allergies in our region. In this study, it was evaluated retrospectively files of cases who had gastrointestinal complaints and cases who detected food allergy and admitted Pediatric Gastroenterology clinic from November 2007 to December 2009. It was diagnosed as a food allergy them if cases who had a positive food specific IgE and/or a positive skin prick test, when these were negative, cases who lost their complaints by elimination of food suspecting. Patients were divided as children <1 year of age and those >1 year of age according to age groups. The study included 63 cases. Boy/ girl ratio was equal. 39,6 % of cases were >1 year of age group, 60,4 % of cases were <1 year of age group. The median period of follow-up was ten and a half months (range: 4-28 month) and the median period of dietary was eight months (range: 4-24 month). The most common reason for admission was proctocolitis (33 %) (bloody and/or mucus in diarrhoea) and ratio of symptoms of gastroeosaphageal reflu was 28 %. 39,6% of all cases had an atopic family history. 65 % of all cases had a positive skin prick test. 84,2 % of cases >1 year of age had a positive food specific IgE while 36 % of cases <1 year of age had a positive food specific IgE. The ratios of sensivity for cow’s milk, egg, peanut, multiple allergen were % 65, 8 % and % 8, respectively. Positivity of food specific IgE was significantly lower in cases with proctocolitis than those admitted with findings of GOR and enteritis (p<0.05). Cow’s milk was a responsible food for 81 % of cases with proctocolitis. Total seven cases admitted findings of proctocolitis and those diagnosed as cow’s milk protein allergy were repeatedly administered therapy for amebiasis. In case of food allergies affecting the gastrointestinal tract, the history and clinical evaluation are more valuable than the laboratory, especially in infants younger than 1 year of age. Allergic proctocolitis should be considered although allergy tests are negative, in patients admitted with lower gastrointestinal bleeding and those had no another detectable cause.
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İnek sütü protein alerjisi, Proktokolit, Gastrointestinal besin alerjisi, Cow’s milk protein allergy, Proctocolitis, Gastrointestinal food allergy, Retrospektif çalışmalar, Retrospective studies, Allerji ve immünoloji, Allergy and immunology, Besin alerjisi, Food hypersensitivity
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Soylu, E. (2010). Besin alerjili çocuk hastaların klinik ve laboratuvar özelliklerinin retrospektif olarak değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
