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Prospective Incidences And The Relationship Between Allergic Proctocolitis And IgE-Mediated Food Allergies In Early Childhood
Monday, March 6, 2017: 3:00 PM
Rooms B312-B313 (Georgia World Congress Center, Building B)
Victoria J. Martin, MD, , , , ,
Rationale: Both IgE and non-IgE mediated forms of food allergy are rising in the United States, but the relationship between them is poorly described. 

Methods: The Gastrointestinal Microbiome and Allergic Proctocolitis study is a prospective observational cohort study enrolling 1,000 healthy newborn infants, designed to evaluate the development of Allergic Proctocolitis (AP) and IgE-mediated food allergy (FA) in their first 3 years.

Results: Of the 280 infants who have reached 2 years of age, 44 children (16% cumulative incidence) were diagnosed with AP and 18 children (6%) were diagnosed with FA. Two (0.7%) children had both AP and FA. The rate of FA was no higher among those with AP (p=0.75). Milk was implicated in 42 (95%) of the AP cases, but only 1 (5.5%) FA case.  Egg (72%), peanut (67%), and tree nuts (32%) were most common for FA. For both children with AP and FA, milk was the trigger for their AP, yet egg and peanut were the triggers for FA, and they tolerated milk at 1 year. Lack of breastfeeding at birth was a risk factor for AP (OR 2.8 [1.1,7,0], p=0.038), but not FA (p=0.99). Mode of delivery, perinatal antibiotic exposure, and presence of siblings were not associated with either diagnosis.

Conclusions: The prospective incidences of AP and FA in this suburban US population are high.  Yet there is little apparent association between the development of AP and subsequent development of IgE-mediated food allergy.  Early breastfeeding is protective against AP, but not FA, highlighting potentially different disease mechanisms.