Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study

Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study

Background: Non-immunoglobulin E-mediated gastrointestinal food allergies (non-IgE-GI-FAs) in children with Down syndrome (DS) tend to be more severe, with some children presenting with sepsis-like symptoms. However, the epidemiology of this condition remains unknown. This study aimed to investigate...

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Main Authors: Fumiko Okazaki, MD, Hiroyuki Wakiguchi, MD, PhD, Yuno Korenaga, MD, Mototsugu Shimokawa, PhD, Tsuyoshi Tanabe, MD, PhD, Ken Fukuda, MD, PhD, Masanari Hasegawa, MD, PhD, Miho Shimizu, MD, PhD, Reiji Hirano, MD, PhD, Tadashi Moriwake, MD, PhD, Mai Kawamura, MD, Hiroshi Tateishi, MD, PhD, Ryo Kadoya, MD, PhD, Yasumasa Tsuda, MD, Takaomi Sekino, MD, PhD, Norimichi Tashiro, MD, PhD, Hirofumi Inoue, MD, PhD, Yoshiko Nawata, MD, Makoto Mizutani, MD, PhD, Takashi Maki, MD, Kenji Nakatsuka, MD, PhD, Shunji Hasegawa, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:World Allergy Organization Journal
Subjects:
Down syndrome
Epidemiology
Food allergy
IgE
Sepsis-like
Online Access:http://www.sciencedirect.com/science/article/pii/S1939455125000808
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Summary:Background: Non-immunoglobulin E-mediated gastrointestinal food allergies (non-IgE-GI-FAs) in children with Down syndrome (DS) tend to be more severe, with some children presenting with sepsis-like symptoms. However, the epidemiology of this condition remains unknown. This study aimed to investigate the prevalence rate and clinical characteristics of non-IgE-GI-FAs in children with DS. Methods: This study included 115 children with non-IgE-GI-FAs diagnosed at 13 hospitals in Yamaguchi Prefecture, Japan, between January 1, 2011, and December 31, 2020. The children were classified into DS and non-DS groups, and their clinical characteristics were retrospectively compared. Results: Among the 115 children with non-IgE-GI-FAs, 7 and 108 were included in the DS and non-DS groups, respectively. During the study period, 184 children with DS were born in Yamaguchi prefecture, and 7 developed non-IgE-GI-FAs. In this study, the prevalence rate of non-IgE-GI-FAs was 3.8% (7/184) in children with DS and 0.11% (108/98,989) in children without DS. No significant differences were observed in causative foods, age at onset, age at diagnosis, or age at confirmed clinical remission between the 2 groups. Most children in both groups experienced vomiting and diarrhea, but none had hypothermia. Sepsis-like symptoms, such as lethargy (71.4% vs. 24.1%, P = 0.0150), hypotension (42.9% vs. 0.9%, P = 0.0006), and fever (57.1% and 8.3%, P = 0.0030), were significantly more common in the DS group than in the non-DS group. Conclusions: The prevalence rate of non-IgE-GI-FAs was 3.8% in children with DS and 0.11% in children without DS. Non-IgE-GI-FAs in children with DS were significantly more severe than those in children without DS. Non-IgE-GI-FAs should be considered a differential diagnosis when sepsis-like symptoms are observed in children with DS.
ISSN:1939-4551

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