Characteristics of allergic proctocolitis in early infancy; accuracy of diagnostic tools and factors related to tolerance development

Nilufer Galip,¹ Ozel Yuruker,² Arzu Babayigit¹

¹ Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
² Department of Immunology, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus

Abstract

Objectives: We aimed to overview clinical characteristics of FPIAP with the results of diagnostic tools like APT, SPT and fecal calprotectin levels and the factors associated with tolerance development.
Methods: All patients diagnosed FPIAP at the outpatient clinic between January 2015 and January 2019 were enrolled retrospectively. Data about clinical characteristics, APT or SPT results, fecal calprotectin levels, suspected triggering foods, diet and tolerance status were obtained from the hospital database program and analyzed.
Result: 169 infants with F/M ratio 78/91 were enrolled. The mean age of the study population was 3.68 months (1-35 months, mean age 3.68 ± 4.33). APT was performed 137 of the participants and 126 (92%) of them were positive to at least one food allergens, 14 (48.2%) patients had positivity to at least one of the food allergens on SPT. Specific IgE were done in 90 patients and 12 (13.3%) revealed positive results. Two groups of patients developing tolerance before and after 18 months of age were evaluated; mucoid diarrhea, family history allergic diseases, cow’s milk sensitivity and multiple allergen triggers were statistically significant risk factors for delayed tolerance according to univariate logistic analysis. However, none of these factors were revealed statistical significance in multivariate logistic analysis.
Conclusion: Our study revealed that APT may be a useful tool for programming the elimination diet in breastfeeding mothers. SPT, specific IgE and fecal calprotectin are not necessary for FPIAP management. Multivariate regression analysis showed that none of the evaluated parameters had statistically significant relationship with the tolerance development.
Key words: allergic proctocolitis, atopy patch test, bloody stools, cow’s milk allergy, food allergy