Caracterización de alimentos con manifestaciones alérgicas durante la introducción de la alimentación complementaria en pacientes con diagnóstico de alergia alimentaria seguidos en HOMI, Fundación Hospital Pediatrico de la Misericordia

Abstract

La nutrición es una parte indispensable del ser humano y toma mayor relevancia en los primeros años de la edad pediátrica por su impacto en el crecimiento y desarrollo, con impactos directos en la salud. Las alergias alimentarias constituyen un problema de salud que se ha incrementado en los últimos años, donde toma un papel primordial la alergia a la proteína de la leche de vaca (APLV) siendo esta de las primeras proteínas de origen no humano ingeridas por los niños. Este aumento en la prevalencia que, si bien sigue siendo subestimado tanto en nuestro país como a nivel global dada la falta de unanimidad en criterios diagnósticos y pruebas confirmatorias, constituye un problema de salud pública y nutrición clínica. La importancia del estudio epidemiológico propuesto, nos permitirá tener una primera aproximación en Colombia de los grupos de alimentos característicos de nuestra población que con mayor frecuencia son relacionados con manifestaciones alérgicas durante la introducción de la alimentación complementaria en niños con alergia alimentaria ya diagnosticada; En simultáneo se pretende analizar otras variables implicadas como los métodos de introducción de la alimentación, permitiendo abrir el panorama al personal de salud y establecer en base a esto estrategias preventivas y terapéuticas en el momento de la introducción de la alimentación complementaria en niños sanos. (Texto tomado de la fuente)

Introduction: Pediatric food allergies represent an escalating public health concern, with prevalence often underestimated due to diagnostic inconsistencies, particularly during the complementary feeding phase—a critical period for nutritional development. Objective: To identify local foods associated with allergic manifestations during the introduction of complementary feeding in pediatric patients diagnosed with food allergies. Methods: A descriptive, retrospective, observational study based on a review of electronic medical records of patients aged 1 to 36 months with a confirmed diagnosis of food allergy, treated at HOMI between April 2022 and April 2024. Patients with cancer or immunosuppression were excluded. After ethical approval, data were collected confidentially and analyzed in STATA 15.0 using descriptive statistics. Results: The study included 50 pediatric patients with a mean age of 19.4 months (SD ±9.5); 56% were male. A majority (84%) resided in urban areas, and 78% presented with neurological and developmental comorbidities. Breastfeeding was reported in 64% of cases, though exclusive breastfeeding was noted in only 2%. Clinical manifestations were predominantly gastrointestinal (61.5%), followed by IgE-mediated (30%) and mixed-type reactions (8.5%). The primary allergens identified were cow’s milk (61%) and egg (57%). During follow-up, 48% of patients exhibited symptomatic improvement, and 22% achieved complete remission. No statistically significant associations were found between specific IgE levels and nutritional status indicators, such as height- for-age (p = 0.957), weight-for-age (p =0.37), and weight-for-height (p = 0.803), nor between specific IgE levels and the most common allergens: cow’s milk (p = 0.82) and egg yolk (p = 0.332). Conclusion: cow’s milk and egg were the primary triggers of allergic reactions during the complementary feeding period. The absence of significant associations between specific IgE sensitization and nutritional status underscores the necessity for comprehensive case evaluations and enhanced clinical documentation to improve characterization and monitoring of pediatric food allergies.