Features of differential diagnosis of inflammatory intestinal disease with food allergy in children of breast age

Authors

DOI:

https://doi.org/10.15574/SP.2022.124.79

Keywords:

inflammatory bowel disease, allergic proctocolitis, diet diagnostics, differential diagnosis, rectal bleeding

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory disease that affects the gastrointestinal tract and includes ulcerative colitis (ulcerative colitis) and Crohn's disease. Symptoms often include abdominal pain, weight loss, hematochezia, and diarrhea, although some patients may experience more insidious gastrointestinal and extraintestinal manifestations. Allergic proctocolitis caused by dietary protein (FPIAP) is a condition characterized by inflammatory changes in the distal parts of the colon in response to one or more foreign dietary proteins due to immune-mediated reactions. Clinically similar to IBD. Delay in the diagnosis of IBD, especially Crohn's disease, remains common in children, and potential complications due to these delays require effective differential diagnosis.

Purpose - on the example of a clinical case to show the features of the differential diagnosis of IBD and FPIAP.

Clinical case. Child A., 2 months old, has a green stool of liquid consistency, sometimes with mucus, abdominal pain. According to laboratory tests, high levels of fecal calprotectin and eosinophilic cationic protein were detected. Diet diagnostics in the form of an elimination diet and provocative tests were used. Due to which significant allergens have been identified and excluded from the mother’s diet.

Conclusions. Determination of fecal calprotectin levels, fecal occult blood analysis, and serum IgE are important in the differential diagnosis of IBD and FPIAP. Timely diagnosis and rational therapy, prevents the development of severe consequences and improves the condition of patients.

The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.

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Published

2022-05-30