UNSOLVED PROBLEMS OF FOOD ALLERGY IN CHILDREN
Abstract
Introduction. The article discusses the most signifi cant problems faced by a pediatrician, family medicine physician, and allergist-immunologist when caring for children with food allergy (FA). Unsolved problems of FA still include the heterogeneity of information about its prevalence and age dynamics. The clinical value of various examination methods are discussed, revealing the main common errors in the interpretation of tests. Cases of unjustifi ed prescription of elimination diets in children with unproven PA are considered. We present our own data obtained during observation of cohorts of pediatric patients in the city allergology offi ce of St. Petersburg. Among 263 children diagnosed with bronchial asthma, in 91 cases (34.6%) positive (>0.35 IU/ml) specifi c IgE was found in the blood serum to food products (in descending order of frequency): chicken egg white, milk, cod, wheat, soy, oats. The development of respiratory symptoms when consuming certain products was recorded in 16 people (6.1% of the sample). The paper provides clinical characteristics of this small subgroup of children with bronchial asthma who are indicated for an individually selected elimination diet. The advantages and disadvantages of a promising method of treating FA - oral immunotherapy with food allergen — are considered. The method provides protection against the development of a severe and life-threatening episode if the patient accidentally consumes food allergen. The advantages and disadvantages of the most popular strategies in the prevention of FA in children, starting from the prenatal period, including the use of hydrolyzed formulas and the introduction of potentially allergenic products into complementary foods, were assessed. Conclusion. In the fi eld of prevention, diagnosis and treatment of food allergies in children at the present stage, there are signifi cant unresolved problems. The development and approval of recommendations for conducting food challenge tests is required. Interpretation of tests can only be carried out in direct connection with knowledge of the history and clinical picture of the disease in the child. The problem of food allergies continues to focus the eff orts of both the international community and domestic scientists.
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