Manifestasi Klinis Berbagai Alergi Makanan Gastrointestinal Pada Usia Anak

Alergi makanan gastrointestinal adalah spektrum gangguan yang diakibatkan reaksi simpang respon imun terhadap antigen makanan. Gangguan tersebut mencakup hipersensitivitas gastrointestinal imediet (anafilaksis), sindrom alergi oral, alergi eosinophilic esophagitis, gastritisgastroenterocolitis,  “Dietary protein enterocolitis”, proktitis, dan enteropati; dan penyakit seliak. Gangguan lain kadang-kadang dikaitkan dengan alergi makanan termasuk kolik, gastroesophageal refluks, dan konstipasi. Dokter anak kadang menghadapi beberapa kesulitan dan tantangan dalam menangani gangguan ini karena dalam menerapkan diagnosis memerlukan kecermatan dalam menyingkirkan gangguan alergi penyebab lain yang sangat banyak tetapi dengan gejala yang sama, Demikian pulan dalam penanganannya tidak mudah karena faktor kesulitan melakukan  identifikasi makanan penyebab, penerapan diet terapi atau obat-obatan, dan pemantauan penanganan gangguan ini

Manifestasi Klinis Alergi makanan Gastrointestinal Pada Usia Anak 

GANGGUAN TANDA DAN GEJALA KLINIS
IgE antibody mediated, acute onset
 Immediate gastrointestinal hypersensitivity Onset Akut: mual, muntah, nyeri perut, diare setelah mengkonsumsi susu, telor, gandum, kedelai, kacang atau ikan laut
 Oral allergy syndrome Pruritus, edema ringan, gangguan kavum oral karena  IgE antibodies originally dipicu sensitisisasi  pollen yang bereaksi silang dengan homologous proteins dalam makanan yang terkandung buah atau sayur.
IgE antibody associated in some cases/cell mediated, delayed-onset/chronic
 Eosinophilic gastroenteropathies
Gejala sangat bervariasi tergantung reaksi inflamasi dari eosinofil; esophagealrefluks: disfagia, nyeri perut; ascites generalisata, gangguan kenaikkan berat badan, protein losing enteropathy, edema, obstruksi
Cell-mediated, delayed-onset/chronic
 Dietary protein enterocolitis Paparan Kronis: muntah, diare, gangguan pertumbuhan, letargi.  reexposure setelah retriksi : emesis, diare, hipotension (15%). Atau 2 jam setelah konsumsi makanan: susu, kedelai atau kacangan-kacangan lainnya
 Dietary protein proctitis Berak lendir, darah.
 Dietary protein enteropathy Malabsorption, edema, emesis, berat badan kurang, biasanya disebabkan karena alergi susu sapi
 Celiac disease Malabsorpsi, diare, respon terhadap gluten, berkaitan denagn HLA-DQ2
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