Y. D'Alfonso

Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation.

BackgroundAllergic proctocolitis (APC) in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT) could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization. Additionally, we assessed the efficacy of an amino acid-based formula (AAF) when multiple food allergy is suspected. amino acid-based formulaMethodsWe have prospectively enrolled 14 exclusively breast-fed infants with APC refractory to maternal allergen avoidance. The diagnosis was confirmed by endoscopy with biopsies. Skin prick tests and serum specific IgE for common foods, together with APTs for common foods plus breast milk, were performed. After a 1 month therapy of an AAF all patients underwent a follow-up rectosigmoidoscopy.ResultsPrick tests and serum specific IgE were negative. APTs were positive in 100% infants, with a multiple positivity in 50%. Sensitization was found for breast milk in 100%, cows milk (50%), soy (28%), egg (21%), rice (14%), wheat (7%). Follow-up rectosigmoidoscopy confirmed the remission of APC in all infants.ConclusionsThese data suggest that APT might become a useful tool to identify subgroups of infants with multiple gastrointestinal food allergy involving a delayed immunogenic mechanism, with the aim to avoid unnecessary maternal dietary restrictions before discontinuing breast-feeding.

Cow's milk allergy and rolandic epilepsy: a close relationship?

Over many years in paediatric allergology we (SL and TF) have observed a higher incidence of allergy in the children with epilepsy and their immediate families than in the controls and their families.1 It has nevertheless proved impossible to demonstrate a strict correlation between allergy and epilepsy, and most of the reports are anecdotal and open to any and every aetiological hypothesis.2 Interest in food allergy as a cause or aggravating factor of epilepsy was reawakened by Egger, whose studies on children suffering from migraine and/or hyperactive syndrome reported an improvement in the convulsive symptomatology subsequent to an oligoantigenic diet.3 Rolandic epilepsy is the best known and described form of idiopathic epilepsy and unquestionably the …

Intestinal lymphoid nodular hyperplasia in children: The relationship to food allergy

Lymphoid nodular hyperplasia (LNH) of the lower gastrointestinal tract is a common finding during paediatric colonoscopies, and its clinical significance has not yet been clearly established.