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
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Online Access:http://www.sciencedirect.com/science/article/pii/S1939455125000808
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author 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
author_facet 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
author_sort Fumiko Okazaki, MD
collection DOAJ
description 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.
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spelling doaj-art-548c8c9538b94d96a68d6ceeafd5d2982025-08-20T03:59:37ZengElsevierWorld Allergy Organization Journal1939-45512025-08-0118810110310.1016/j.waojou.2025.101103Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological studyFumiko Okazaki, MD0Hiroyuki Wakiguchi, MD, PhD1Yuno Korenaga, MD2Mototsugu Shimokawa, PhD3Tsuyoshi Tanabe, MD, PhD4Ken Fukuda, MD, PhD5Masanari Hasegawa, MD, PhD6Miho Shimizu, MD, PhD7Reiji Hirano, MD, PhD8Tadashi Moriwake, MD, PhD9Mai Kawamura, MD10Hiroshi Tateishi, MD, PhD11Ryo Kadoya, MD, PhD12Yasumasa Tsuda, MD13Takaomi Sekino, MD, PhD14Norimichi Tashiro, MD, PhD15Hirofumi Inoue, MD, PhD16Yoshiko Nawata, MD17Makoto Mizutani, MD, PhD18Takashi Maki, MD19Kenji Nakatsuka, MD, PhD20Shunji Hasegawa, MD, PhD21Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, JapanDepartment of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Corresponding author. , Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, JapanDepartment of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, JapanDepartment of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, JapanDepartment of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Division of Pediatrics, Shuto General Hospital, Yanai, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi Grand Medical Center, Hofu, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi Grand Medical Center, Hofu, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi-ken Saiseikai Shimonoseki General Hospital, Shimonoseki, Yamaguchi, JapanDivision of Pediatrics, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Yamaguchi, JapanDepartment of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan; Division of Pediatrics, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Yamaguchi, JapanDivision of Pediatrics, Japan Community Health Care Organization Tokuyama Central Hospital, Shunan, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi Red Cross Hospital, Yamaguchi, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi Red Cross Hospital, Yamaguchi, Yamaguchi, JapanDivision of Pediatrics, Ogori Daiichi General Hospital, Yamaguchi, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi Rosai Hospital, Sanyo-Onoda, Yamaguchi, JapanDivision of Pediatrics, Hagi Civil Hospital, Hagi, Yamaguchi, JapanDivision of Pediatrics, Hagi Civil Hospital, Hagi, Yamaguchi, JapanDivision of Pediatrics, Nagato General Hospital, Nagato, Yamaguchi, JapanDivision of Pediatrics, National Hospital Organization Kanmon Medical Center, Shimonoseki, Yamaguchi, JapanDivision of Pediatrics, Yamaguchi-ken Saiseikai Toyoura Hospital, Shimonoseki, Yamaguchi, JapanDepartment of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, JapanBackground: 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.http://www.sciencedirect.com/science/article/pii/S1939455125000808Down syndromeEpidemiologyFood allergyIgESepsis-like
spellingShingle 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
Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study
World Allergy Organization Journal
Down syndrome
Epidemiology
Food allergy
IgE
Sepsis-like
title Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study
title_full Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study
title_fullStr Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study
title_full_unstemmed Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study
title_short Non-immunoglobulin E-mediated gastrointestinal food allergies in children with Down syndrome: An epidemiological study
title_sort non immunoglobulin e mediated gastrointestinal food allergies in children with down syndrome an epidemiological study
topic Down syndrome
Epidemiology
Food allergy
IgE
Sepsis-like
url http://www.sciencedirect.com/science/article/pii/S1939455125000808
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