Nihon Shoni Arerugi Gakkaishi. The Japanese Journal of Pediatric Allergy and Clinical Immunology
The differential diagnosis of food protein-induced enteropathy by intestinal mucosal pathology
Takahiro KudoItsuhiro OkaNobuyasu AraiReiko KyodoMasamichi SatoEri MiyataKenji HosoiSeiichi MatsumuraNaho ObayashiTamaki IkuseKeisuke JimboMari MoriYo AoyagiTohru FujiiYoshikazu OhtsukaToshiaki Shimizu
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Volume 31 (2017) Issue 1 Pages 7-12

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Abstract

 Food protein-induced enteropathy is one of non-IgE-mediated food allergies and develops in infants within 1-year-old, with prolonged diarrhea, vomits, bloody stools, abdominal distention, and if severe malnutrition, failure to thrive and developmental retardation. It is often difficult to diagnose as this disease, therefore early diagnosis and early intervention are important.

 Although the food loading test is the basis for the diagnosis of this, as an objective test, the antigen specific lymphocyte stimulation test on the food antigen is useful for identifying the causative antigen. In endoscopic examination of gastrointestinal tract, inflammatory findings are recognized in the duodenum and colonic mucosa. In pathological examination from mucosal biopsy, inflammatory cell infiltration such as eosinophils and lymphocytes is noticed. Furthermore, food protein induced enteropathy that exhibits malabsorption and failure to thrive evaluates villous atrophy and crypt hyperplasia in duodenal mucosa.

 Since many diseases causing chronic diarrhea exist other than food protein-induced enteropathy, confirming the findings of the gastrointestinal mucosa using endoscopic and histopathological examination helps not only diagnosis, but also indicators for starting enteral nutrition. Therefore, it should be considered to perform the endoscopic examination when food protein-induced enteropathy is suspected.

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© 2017 Japanese Society of Pediatric Allergy and Clinical Immunology
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