Gastrointestinal Sistemin Alerjik Hastalıkları

Öz Gastrointestinal sistemin (GİS) alerjik hastalıkları besin alımına bağlı olarak ortaya çıkan, GİS’in herhangi bir bölümünde görülebilen, bir ya da birden fazla kat-manın etkilendiği eozinofilik inflamasyonla karakterize hastalıklardır. Bu hastalıklar besinlerin kendilerinin ya da içerdikleri herhangi bir maddenin meydana getirdiği immunolojik veya immunolojik olmayan mekanizmalarla tetiklenir. Ortaya çıkış mekanizmasına göre IgE aracılı, IgE aracılı olmayan ve mikst tip olmak üzere üçgrupta incelenir. Görülme sıklığı erişkinde %2 iken, çocukluk yaş grubunda %8’lere kadar çıkabilmektedir. En sık tetikleyici besinlerin inek sütü, yumurta, tahıllar ve soya olduğu bilinmektedir. Özellikle IgE aracılı olmayan GİS alerjilerinde tetikleyici besinin saptanması her zaman kolay olmayabilir ancak bu hastalıkların genellikle 1-3 yaş aralığında mükemmel bir prognozla iyileştiği bilinmektedir. Günümüzde henüz GİS alerjileri ile ilgili aydınlatılmamış birçok soru mevcuttur. Özellikle IgE aracılı olmayan grupta olanlar için geliştirilebilecek tanı araçları ile ilgili çalışmalar devam etmektedir. Bu derlemede, GİS allerjik hastalıklarında klinik bulgular, tanıve tedavi son literatür eşliğinde tartışılacaktır.

Allergic Disorders of Gastrointestinal System

AbstractFood induced gastrointestinal allergic disorders caused by certain food proteinsare characterized by eosinophilic inflammation on any site of the gastrointestinal system.These disorders caused by IgE or non-IgE-mediated immunological reactions that triggered by the food proteins. According to the type of immunological reaction, these disorders can be classified in three groups; IgE mediated, non-IGE-mediated andmixed type food induced allergic disorders. Food allergic reactions typically affects children more than adults; the prevalance in childhood can be as high as 8% while2% in adults. The overall most common allergens are cow’s milk, egg, cereals andsoy. Non IgE-mediated allergic disorders has an excellent prognosis that usually resolves itself by the age 1-3 and usually can not be possible to find the trigger allergen in most of the cases. There is stil an urgent need to define pathophysiological mechanisms of non-IgE-mediated food allergies and to develop diagnostic tools. Inthis review,  clinical characteristics, diagnostic perspectives and treatment options of the food induced gastrointestinal allergic disorders were summarized with the recent literature.

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