Frequency of allergy and congenital immune deficiency in children With lymphonodular hyperplasia

Abstract

The lumen of the gastrointestinal tract is continuously exposed to many food antigens and besides all of its other functions, the gut is a crucial site for the immunologic response. So when immune system does not work well, tolerance to orally administered antigens does not exist. Association of LNH with different immune-mediated disorders, have led to the hypothesis that local immune regulation is involved in its pathogenesis. Also a recent study suggests food allergy is responsible for intestinal symptoms only in a minority of patients. and it is against the other studies which support the association of food allergy and LNH.The aim of this study is to define the frequency of allergy and congenital immune deficiency in children with LNH. Methods: It is a descriptive-cross sectional study. The size of sample is 52 children with the mean age of 5.25±3.2 years. Children with different clinical symptoms who underwent colonoscopy 2010-2017 at Tabriz children hospital were evaluated. Inclusion criteria was isolated LNH in colonoscopy report which done by one expert gastrointestinal subspecialist. Exclusion criteria were polyps, tumors, ulcers reported in colonoscopy,coagulopathy, infectious diarrhea , secondary immune deficiency, inflammatory bowel disease, positive meckel scan.Finally we enrolled 52 patients, their information collected in compliance with ethics.The data were analysed using SPSS16 for descriptive statistics. Results: LNH was observed in 113 of 303(37%) for whom colonoscopy had been indicated during a 7-year period. According to inclusion and exclusion criteria,finally 52 children enrolled (34 male (65%), 18 female (35%), with mean age of 5.25±3.2) who were referred for hematochezia(73%), chronic diarrhea(13%), abdominal pain(10%), constipation(2%) and anemia(2%). Hematochezia was the most frequent clinical presentation in this children. Personal history of allergy was presented in 19(36%) of patients and family history of allergy was presented in 14(27%) of patients, respectively. Pathology reported infiltration of mixed inflammatory cells in 30 of 50(60%) patients.The most frequency of allergy was reported in children with nonspecific changes at pathology report.Two of patients have primary immune deficiency included humoral and combined type.