Alergia a proteína do leite de vaca em pediatria com manifestação gastrointestinal: uma revisão da literatura

Abstract

Introduction: Food allergy or hypersensitivity (AA) is defined as a local or systemic clinical reactions after ingestion of allergenic food proteins. They are immunological reactions, and may be due to mediated IgE, non-IgE or mixed IgE mechanisms. In the pediatric age group, the most common allergenic protein is cow's milk protein (OPV), especially in children younger than 3 years of age, although allergy to cow's milk protein (APLV) with GI manifestations can be diagnosed in all age groups. In the vast majority, the initial symptoms are nonspecific, so it is common to delay diagnosis. This delay entails significant morbidity in the short and long term, especially in childhood, where feeding is essential for growth and development. AA, if not adequately treated, is associated with significant morbidity, negatively impacting the child's survivaland quality of life. Objectives:To review the literature on the theme "Cow's milk protein allergy", with a focus on diagnostic aspects and assertive treatment, in order to avoid erroneous labeling of disease in a healthy child. Methods: A review of the literature was made in the main bases of scientific medical articles such as PubMed, Scielo. The articles were selected mainly in the form of review, guidelines and with aspects that addressed the diagnosis and treatment of APLV. Conclusion: The diagnosis of AA non-IgE mediated is more laboratory-limited, but a well-done clinical history and physical examination followed by a restriction diet and a subsequent challenge test are largely sufficient for a precise diagnosis. When the diagnosis is late, many patients already present weight-stature deficit. There is a difficulty in carrying out the exclusion diet due to the large food restriction, depending on the suspected protein, making the diet very poor and easy to be transgressed. The elimination diet significantly affects the quality of life of allergic children and their families due to social restriction and risk of accidental reactions, and there is also a fear of the child and his / her caregivers with new foods.