Vitamin D Status in Young Children with Gastrointestinal Manifestations of Food Allergy
DOI:
https://doi.org/10.15574/SP.2021.113.74Keywords:
gastrointestinal manifestations of food allergy, young children, vitamin DAbstract
Aim is to investigate vitamin D status in young children with gastrointestinal manifestations of food allergy.
Materials and methods. 30 children aged 4 months to 3 years with enterocolitis syndrome induced by dietary proteins were examined. General clinical examination included assessment of physical and somatic status (body weight, height, sleep, appetite), condition of the skin and mucous membranes, skeletal system, internal organs, nature and frequency of bowel movements. To assess vitamin D status in children with gastrointestinal allergy, we used quantitative determination of the concentration of 25 (OH) D (25-hydroxycalciferol) in blood serum using the Architect 2000sr I «ABBOT» immunochemical assay (USA). Complex treatment of the underlying disease involved correction of vitamin D deficiency using the drug «Aquadetrim» containing aqueous solution of colecalciferol for oral administration at a dose of 2000 U/day for 1 month. The comparison group included 20 children aged 12–24 months with non$aggravated individual and family history of allergies, who had functional diseases of the gastrointestinal tract (functional constipation, functional diarrhea, flatulence syndrome) and did not take vitamin D preparations. The data of clinical and laboratory trials were processed by the methods of mathematical statistics adopted in biology and medicine. The reliability of differences in comparative indicators was determined using the Student's t-test and nominal data using Fisher's exact test.
Results and conclusions. Based on the results of assessing the vitamin D status in young children with gastrointestinal food allergy by determining serum concentrations of 25-hydroxycalciferol, vitamin D deficiency was established in 86.7% of patients — with average of 26.39 (21.08–29.98) ng/ml. Administration of aqueous solution of colecalciferol (Aquadetrim) at a dose of 2000 IU per day for 1 month to children with gastrointestinal food allergy helped to normalize the concentration of 25-hydroxycalciferol in blood serum of 92.3% of children. Against the background of the use of the vitamin D preparation (Aquadetrim), there were no cases of deterioration of gastrointestinal and skin manifestations of the disease; «Akvadetrim» preparation was well tolerated, without side reactions.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
References
Caubet JC, Szajewska H, Shamir R, Nowak-Wegrzyn A. (2017, Feb). Non-IgE-mediated gastrointestinal food allergies in children. Pediatr Allergy Immunol. 28(1):6-17. https://doi.org/10.1111/pai.12659; PMid:27637372
Clark A, Mach N. (2016). Role of vitamin D in the hygiene hypothesis: the interplay between vitamin D, vitamin D receptors, gut microbiota,and immune response. (Report). Front Immunol. 7:627. https://doi.org/10.3389/fimmu.2016.00627
Errazuriz G, Lucero Y, Ceresa S, Gonzalez M, Rossel M, Vives A. (2016). Clinical characteristics and management of infants less than 1 year old suspected with allergy to cow's milk protein. Rev Chil Pediatr. 87(6):449-54. https://doi.org/10.1016/j.rchipe.2016.06.007; PMid:27634007
Gupta RS, Springston EE, Warrier MR, et al. (2011). The prevalence, severity and distribution of childhood food allergy in the United States. Pediatrics, 128(1):e9-17. https://doi.org/10.1542/peds.2011-0204; PMid:21690110
Holick MF, Binkley NC, Bischoff>Ferrari HA, et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin. Endocrinol Metab. 96: 1911-1930. https://doi.org/10.1210/jc.2011-0385; PMid:21646368
Ho MHK, Wing WHS, Chang C. (2014). Clinical spectrum of food allergies: a comprehensive review. Clinical Reviews in Allergy and Immunology. 46(3):225-240. https://doi.org/10.1007/s12016-012-8339-6; PMid:23229594
Koletzko S, Heine RG, Grimshaw KE, et al. (2015). Non-IgE mediated cow's milk allergy in Euro Prevall. Allergy. 70(12):1679-80. https://doi.org/10.1111/all.12681; PMid:26769086
Kolokotroni O, Middleton N, Kouta C, Raftopoulos V, Yiallouros PK. (2015). Association of Serum Vitamin D with Asthma and Atopy in Childhood: Review of Epidemiological Observational Studies. Mini Rev Med Chem. 15(11): 881-899. https://doi.org/10.2174/1389557515666150519105541; PMid:25985951
Kvashnina LV. (2017). Vitamin D u rizni periody dytynstva: shcho znaiemo, shcho treba pamiataty i shcho zabuty. Zdorovia Ukrainy: 29-31.
Lopez-Gonzalez D, Mendez-Sanchez L, Guagnelli MA, Clark P. (2015). Vitamin D deficiency in childhood: an opportunity for prevention. Bol Med Hosp Infant Mex. 72(4): 225-234. https://doi.org/10.1016/j.bmhimx.2015.01.011; PMid:29421141
Murano A, Werfel T, Hoffmann-Sommergruber K, et al. (2014, Aug). EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 69(8):1008-25. https://doi.org/10.1111/all.12453; PMid:24888964
Nowak-Wegrzyn A, Chehade M, Groetch ME, Spergel JM, Wood RA, Allen K, et al. (2017). International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: Executive summary - Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy Asthma & Immunology. J Allergy Clin Immunol. 139(4):1111-26.
Nwaru BI, Hickstein L, Panesar SS, Muraro A, Werfel T, Cardona V, et al. (2014, Jan). On behalf of the EAACI Food Allergy and Anaphylaxis Guidelines Group. The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy. 69(1):62-75. https://doi.org/10.1111/all.12305; PMid:24205824
Pae M, Wu D. (2017). Nutritional modulation of age-related changes in the immune system and risk of infection. Nutr Res. 41:14-35. https://doi.org/10.1016/j.nutres.2017.02.001; PMid:28577789
Palmer MT, Lee YK, Maynard CL, et al. (2011). Lineage-specific effects of 1,25-dihydroxyvitamin D(3) on the development of effector CD4 T cells. J Biol Chem. 286:997. https://doi.org/10.1074/jbc.M110.163790; PMid:21047796 PMCid:PMC3020784
Poole A, Song A, Brown H, Hart P H. (2018, Jul). Cellular and molecular mechanisms of vitamin D in food allergy. J Cell Mol Med. 22(7):3270-3277. https://doi.org/10.1111/jcmm.13607; PMid:29577619 PMCid:PMC6010899
Prescott SL, Pawankar R, Allen KJ, et al. (2013). A golabl survey of changing patterns of food allergy burden in children. World Allergy Organization Journal. 6(21). https://doi.org/10.1186/1939-4551-6-21; PMid:24304599 PMCid:PMC3879010
Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M ls in rural Canadian children. Paediatr Child Health. 22(3): 125-129. https://doi.org/10.1093/pch/pxx007; PMid:29479197 PMCid:PMC5804950
Tolppanen AM, Sayers A, Granell R, Fraser WD, Henderson J, Lawlor DA. (2013). Prospective association of 25-hydroxyvitamin d3 and d2 with childhood lung function, asthma, wheezing, and flexural dermatitis. Epidemiol. 24(2): 310-319. https://doi.org/10.1097/EDE.0b013e318280dd5e; PMid:23377091
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Modern Pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.