Abstract
Although patients with neonatal and infantile gastrointestinal (GI) allergy (GI allergy) show various GI symptoms, the severity of the disease cannot be properly defined by GI symptoms alone. Recently, fever and the increased serum CRP level were demonstrated to be reproduced by an oral food challenge test. These findings may help estimate the severity of the disease. Among patients with GI allergy, those patients showing fever and high serum CRP levels with undefined GI symptoms (septicemia-like phenotype) should be classified into the most severe disease type because of the seriousness and urgency. Patients with vigorous and prolonged vomiting should be classified into the severe disease type because of a risk of dehydration and hypovolemic shock. Patients manifesting poor weight gain with diarrhea should be classified into the intermediate disease type because of the serious systemic influence causing growth failure. Infants with the severe and intermediate disease type often present a mild increase in the serum CRP levels and abnormal findings in imaging examinations. Patients presenting diarrhea or bloody stool without any systemic symptoms or abnormal laboratory findings are classified into the mild disease type. All patients with GI allergy should be treated properly based on the appropriate grading of the disease severity.
