PDF(Pubmed)
Abstract：
Food-protein-induced allergic proctocolitis (FPIAP) is an increasingly reported transient and benign form of colitis that occurs commonly in the first weeks of life in healthy breastfed or formula-fed infants. Distal colon mucosal inflammation is caused by a non-IgE immune reaction to food allergens, more commonly to cow\'s milk protein. Rectal bleeding possibly associated with mucus and loose stools is the clinical hallmark of FPIAP. To date, no specific biomarker is available, and investigations are reserved for severe cases. Disappearance of blood in the stool may occur within days or weeks from starting the maternal or infant elimination diet, and tolerance to the food allergen is typically acquired before one year of life in most patients. In some infants, no relapse of bleeding occurs when the presumed offending food is reassumed after a few weeks of the elimination diet. Many guidelines and expert consensus on cow\'s milk allergy have recently been published. However, the role of diet is still debated, and recommendations on the appropriateness and duration of allergen elimination in FPIAP are heterogeneous. This review summarizes and compares the different proposed nutritional management of infants suffering from FPIAP, highlighting the pros and cons according to the most recent literature data.
摘要：
食物蛋白诱导的过敏性直肠结肠炎（FPIAP）是一种越来越多报道的短暂性和良性结肠炎形式，通常发生在健康母乳喂养或配方喂养的婴儿出生后的头几周。远端结肠粘膜炎症是由对食物过敏原的非IgE免疫反应引起的，更常见的是牛奶中的蛋白质。可能与粘液和稀便有关的直肠出血是FPIAP的临床标志。迄今为止,没有特定的生物标志物可用，调查是针对严重案件的。在开始母亲或婴儿消除饮食后的几天或几周内，粪便中的血液可能会消失，对食物过敏原的耐受性通常是在大多数患者生命一年之前获得的。在一些婴儿中，如果在消除饮食几周后重新使用假定的不良食物，则不会发生出血复发。最近发表了许多关于牛奶过敏的指南和专家共识。然而,饮食的作用仍然存在争议，关于FPIAP中过敏原消除的适当性和持续时间的建议是不同的。这篇综述总结并比较了FPIAP婴儿的不同营养管理建议，根据最新的文献资料，突出利弊。
