Food Allergy Symptoms

In the process of the evolution of the symptoms of food allergy, there are 3 stages:

1. A clear connection of the clinical picture with food provocation and a clear (before the disappearance of symptoms) effect of elimination measures.
2. Chronic course of the disease with food dependence: the severity of clinical manifestations is associated with the allergenic diet, but to achieve a stable state of remission, even with prolonged elimination is no longer possible.
3. Complete nutritional independence. Formed chronic disease continues to develop on the basis of the inclusion of secondary pathogenetic chains.

Clinical manifestations of lesions of the gastrointestinal tract with food allergies depend on the localization of the process and the age of the child. Characteristic for children of early age is the severity and generalization of the process. Clinically expressed gastrointestinal syndrome is registered in 1.9% of children in the first year of life. The most frequent in this case are diarrhea, vomiting, abdominal pain, the phenomenon of colitis, the loss of erythrocytes with feces.

At the age of more than a year, a subacute and chronic course with a more distinct localization of the lesion is often noted. Abdominal pain is a frequent manifestation of food allergy in children of any age. It can proceed according to the type of colic associated with dyskinetic phenomena, be of a short-term nature with localization in the navel. The appearance of pain in the epigastric region is often due to the hyperacid state that develops under the action of the released histamine. The causes of abdominal pain in food allergy are acute and chronic allergic lesions of the gastrointestinal tract (gastritis, duodenitis, enteritis, etc.).

The importance of food allergy in the occurrence of ulcerative lesions of the gastrointestinal tract is proved. Allergic inflammation of the intestinal mucosa leads to significant changes in the parietal microbial landscape (the number of bifidobacteria decreases and the content of Escherichia coli and enterococcus increases). Prolonged course of the disease can lead to the formation of secondary enzymatic deficiency with the development of malabsorption syndrome of lactose, gliadin cereals (secondary celiac disease), exudative enteropathy. Often develop cholecystopathy, hepatocholecystopathy, hypoferment, primarily with pancreatic enzyme deficiency, which is accompanied by an increase in absorption of antigens of protein origin.

One of the first symptoms of food allergies can be an elective appetite.

The frequency and severity of skin lesions with food allergies largely depends on the child's age. For the first half of the year, childhood eczema, limited atopic dermatitis, which occur against the background of breastfeeding or the introduction of supplementary feeding, complementary feeding and food correction, are characteristic.

Typical symptoms of food allergies include Quincke's edema and hives. Among the local forms of skin lesions, it should be noted the syndrome of perioral allergy, which often develops on products of plant origin, which have a cross-allergenic effect with pollen of plants.

One of the varieties of food allergy, in which IgE is not proven, is herpetiform dermatitis. It manifests an itchy rash in combination with signs of gluten enteropathy. Children more often are ill 2-7 years. Characterized by the appearance of erythematous polymorphous rashes with predominant localization in the region of the knees, elbows, shoulders, buttocks, scalp. In the area of the palms and soles, the rashes can be hemorrhagic. Skin and intestinal manifestations of the disease react to the abolition of gluten, but the dynamics of skin renewal lags behind the normalization of the functioning of the intestine.

The defeat of the respiratory system in food allergies is often manifested by allergic rhinitis and rhinosinusitis. Most often in children before the year, allergic rhinitis is caused by a reaction to cow milk and vegetable juices. At the older age, grains become more important.

The manifestation of IIA in young children can be acute subglottic laryngitis, developing a few minutes after the use of a causally significant food allergen. Hyperplasia of lymphoid tissue with IIA can lead to the formation of adenoiditis and chronic tonsillitis.

Bronchial asthma of food etiology is relatively rare. IM Vorontsov proposed the term "asthma of the second target," because in this case, the attack of suffocation develops with the use of the allergen inside and depends on the remote action of biologically active substances. Aerosol contact with an allergen can occur on the smell of fish, inhaling allergen nuts. Food allergens play a significant role in the development of exogenous allergic alveolitis.

Heiner's syndrome is a rare form of primary hemosiderosis of the lungs caused by hypersensitivity to cow's milk. The disease occurs in young children and manifests itself with wheezing, shortness of breath, chronic cough, intermittent infiltrates in the lungs, hypochromic microcytic anemia and growth retardation. In sputum and gastric aspirate, hemosiderin-laden macrophages (siderophages) can be detected. The patient's condition improves after excluding cow's milk from the diet.

With food allergies are associated with vegetative disorders, increasing with age, the characteristics of behavior, the difficulties of schooling. Food allergies can cause severe generalized allergic reactions: anaphylactic and anaphylactoid shock, hemorrhagic and other generalized vasculitis. In the literature, some cases of sudden death syndrome are associated with an allergic reaction to cow milk.

When microscopic mucus from the stool can detect a large number of eosinophils. In the formulation of the diagnosis, the elimination of allergen from food is helpful - an elimination test , and vice versa, the appointment of an allergen is a provocative test and the emergence of clinical manifestations. It is important and the response from the peripheral blood in the form of leukopenia and eosinophilia.

The diagnosis can be confirmed by the determination of antibodies in blood serum by the method of indirect immunoassay (ELISA), the detection of specific IgE antibodies by radioimmunosorbent test.

[1], [2], [3], [4], [5], [6]