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Комментарии к практическим рекомендациям ESPGHAN по диагностике и лечению аллергии к белкам коровьего молока у детей грудного и раннего возраста
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Vandenplas I., Zakharova I.N., Dmitrieva Yu.A. Comments to the practical recommendations ESPGHAN diagnosis and treatment of allergy to cow's milk protein in infants and young children. Consilium Medicum. Pediatrics (Suppl.). 2016; 3: 7–12.
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Ключевые слова: белки коровьего молока, пищевая аллергия, гастроинтестинальные симптомы, пищевые аллергены, дети грудного и раннего возраста, младенцы, рвота, анафилаксия, крапивница, атопический дерматит, толерантность, биопсия, кожные пробы, лабораторные тесты, скарификационные тесты, диетотерапия, диетодиагностика.
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The steady increase in the frequency of allergic diseases is currently the focus of scientists. Particular attention is paid to the research capabilities of timely diagnosis and effective prevention of food allergy in infants. The variability of the clinical picture, the complexity of interpretation of results of laboratory tests, the difficulties of differential diagnosis between IgE- or IgE-mediated food allergy options identified the need to develop a standardized protocol of patient management based on the principles of evidence-based medicine. In 2012, a group of experts of the European Society of Children's Gastroenterology, Hepatology and Nutrition (ESPGHAN) published diagnostic protocol and treatment of allergy to cow's milk protein in infants and young children. In this paper, the authors analyzed the main provisions of the consensus position of existing national practice management of children with allergies to cow's milk protein.
Key words: cow's milk protein, food allergies, gastrointestinal symptoms, food allergens, infants and young children, infants, vomiting, anaphylaxis, urticaria, atopic dermatitis, tolerance, biopsy, skin tests, laboratory tests, scratch test, diet, diet diagnostics.
2. Høst A, Halken S, Jacobsen HP et al. Clinical course of cow's milk protein allergy/intolerance and atopic diseases in childhood. Pediatr Allergy Immunol 2002; 13 (Suppl. 15): 23–8.
3. Koletzko S, Niggemann B, Arato A et al. Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr 2012; 55 (2): 221–9.
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5. American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics 2000; 106 (2 Pt. 1): 346–9.
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1. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol 2011; 127 (3): 594–602.
2. Høst A, Halken S, Jacobsen HP et al. Clinical course of cow's milk protein allergy/intolerance and atopic diseases in childhood. Pediatr Allergy Immunol 2002; 13 (Suppl. 15): 23–8.
3. Koletzko S, Niggemann B, Arato A et al. Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr 2012; 55 (2): 221–9.
4. Greer FR, Sicherer SH, Burks AW. Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Pediatrics 2008; 121: 183–91.
5. American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics 2000; 106 (2 Pt. 1): 346–9.
1 Университетская клиника Брюсселя, Свободный университет Брюсселя, Брюссель, Бельгия;
2 ФГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
*zakharova-rmapo@yandex.ru
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I.Vandenplas1, I.N.Zakharova*2, Yu.A.Dmitrieva2
1 University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium;
2 Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*zakharova-rmapo@yandex.ru