Long-term risk of allergic diseases after allergic proctocolitis

Background The long-term progression of allergic conditions in children with a history of food protein-induced allergic proctocolitis (FPIAP) remains unclear. Objective To assess the prevalence and clinical characteristics of allergic diseases, particularly asthma, in patients with a history of FPIAP. Methods In this retrospective case-control study, we included 170 patients diagnosed with having FPIAP (median age [IQR]: 7.4 [6.9-8.0] years) who developed tolerance at a median age of 12 months (IQR: 10.0-14.0). Control groups comprised patients with non-food allergy (non-FA; n = 101), outgrown IgE-mediated cow’s milk allergy (IgE-CMA; n = 97), and current IgE-CMA (n = 100). The proportions of asthma and allergic rhinitis (AR) were compared among the groups. Results The FPIAP group exhibited a higher risk of developing asthma and AR than the non-FA group did (asthma: adjusted odds ratio: 4.273, 95% CI: 2.173-8.403, P < .001; AR: adjusted odds ratio: 3.039, 95% CI: 1.199-7.692, P = .019). The proportions of asthma and AR in the FPIAP group (45.2% and 17.6%, respectively) were significantly higher than those in the non-FA group (12.9%, P < .001; 5.9%, P = .006) but lower than those in the current IgE-CMA group (74%, P < .001; 36%, P = .001). No significant differences were observed between the FPIAP and outgrown IgE-CMA groups. However, patients with FPIAP exhibited poorer asthma control than those in the IgE-mediated CMA groups did. Conclusion Children with a history of FPIAP are at an increased risk of developing asthma and AR, necessitating ongoing monitoring. Further research is needed to clarify the role of FPIAP in the allergic march.