medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-371medsovet-9610Research ArticleАЛЛЕРГОЛОГИЯ И ИММУНОЛОГИЯALLERGOLOGY AND IMMUNOLOGYСложности диагностики не-IgE-зависимой пищевой аллергии у младенцевChallenges in diagnosing non-IgE dependent food allergy in infantshttps://orcid.org/0000-0002-2847-6268БережнаяИ. Н.BerezhnayaI. B.

Бережная Ирина Владимировна, к.м.н., доцент кафедры педиатрии имени академика Г.Н. Сперанского; врач-педиатр, гастроэнтеролог

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

125373, Москва, ул. Героев Панфиловцев, д. 28

Irina B. Berezhnaya, Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics named after Academician G.N. Speransky; Pediatrician, Gastroenterologist

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

28, Geroyev Panfilovtsev St., Moscow, 125373

berezhnaya-irina26@yandex.ruhttps://orcid.org/0000-0003-4200-4598ЗахароваИ. Н.ZakharovaI. N.

Захарова Ирина Николаевна, д.м.н., профессор, заслуженный врач РФ, заведующая кафедрой педиатрии имени академика Г.Н. Сперанского

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Irina N. Zakharova, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of Academician G.N. Speransky Department of Pediatrics

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

zakharova-rmapo@yandex.ruhttps://orcid.org/0009-0005-2121-4010ОробинскаяЯ. В.OrobinskayYa. V.

Оробинская Яна Владимировна, ассистент кафедры педиатрии имени академика Г.Н. Сперанского; врач-педиатр

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

141400, Московская обл., Химки, ул. Родионова, д. 1

Yana V. Orobinskaya, Assistant of the Department of Pediatrics named after Academician G.N. Speransky; Pediatrician

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

1, Rodionov St., Khimki, Moscow Region, 141400

yanashbook@mail.ruhttps://orcid.org/0000-0002-1593-0732ДмитриеваД. К.DmitrievaD. K.

Дмитриева Диана Кирилловна, аспирант кафедры педиатрии имени академика Г.Н. Сперанского

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Diana K. Dmitrieva, Postgraduate Student of the Department of Pediatrics named after Acad. G.N. Speransky

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

dmitrievadi@mail.ruРоссийская медицинская академия непрерывного профессионального образования; Детская городская клиническая больница имени З.А. БашляевойРоссияRussian Medical Academy of Continuous Professional Education; Bashlyaeva Children’s City Clinical HospitalRussian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationРоссийская медицинская академия непрерывного профессионального образования; Поликлиника «Мама и малыш», Химкинская клиническая больницаРоссияRussian Medical Academy of Continuous Professional Education; Mother and Baby Outpatient Clinic, Khimki Clinical HospitalRussian Federation202501122025019236–246Copyright © Бережная И.Н., Захарова И.Н., Оробинская Я.В., Дмитриева Д.К., 20252025Бережная И.Н., Захарова И.Н., Оробинская Я.В., Дмитриева Д.К.Berezhnaya I.B., Zakharova I.N., Orobinskay Y.V., Dmitrieva D.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9610

Пищевая аллергия – это результат иммунных реакций, вызывающих негативный ответ организма на продукты питания. Эти реакции могут проявляться различными симптомами и расстройствами, включая острые аллергические проявления, анафилаксию, аллергический проктоколит, вызванный пищевыми белками, синдром энтероколита, а также синдром пыльцевой пищевой аллергии. Кроме того, пищевая аллергия способствует развитию хронических воспалительных заболеваний, таких как эозинофильный эзофагит и атопический дерматит. Пищевая аллергия – это одна из наиболее распространенных форм аллергий у младенцев, и за последние годы ее распространенность увеличилась. Ее наличие приводит к серьезным нарушениям качества жизни, как индивидуальным, так и семейным, а также создает личные и социальные издержки. Понимание диагностических особенностей этого состояния необходимо для правильного ведения пациентов, назначения элиминационной диеты, определения оптимального времени для проведения перорального провокационного теста и расширения рациона. Важность знания диагностических критериев заключается в предотвращении гипердиагностики, снижении числа ненужных ограничений, сохранении грудного вскармливания или подборе корректных заменителей грудного молока. Первым шагом в лечении пищевой аллергии является постановка точного диагноза, основанная на анализе клинической картины и исключении продукта, вызывающего реакцию, чаще всего коровьего молока. Этот процесс сопряжен с трудностями и рисками для питания, поэтому требует особого внимания. Представлен клинический случай: пациент, девочка 2 мес., с жалобами на сыпь по всему телу, склонность к запорам, отказ от груди. Подробно описаны симптомы пищевой аллергии и принципы диеты и терапии. Лечение пищевой аллергии предполагает выполнение диагностических алгоритмов, разработку индивидуального плана питания и своевременную оценку развития толерантности. Все это направлено на снижение нагрузки на организм и минимизацию рисков, связанных с питанием.

Food allergies result from immune response that causes the body to react negatively to food products. These reactions can manifest as a wide variety of symptoms and disorders, including acute allergic reactions, anaphylaxis, food protein-induced allergic proctocolitis, enterocolitis syndrome, and pollen food allergy syndrome. In addition, food allergies contribute to the development of chronic inflammatory diseases such as eosinophilic esophagitis and atopic dermatitis. Food allergies are one of the most common forms of allergy in infants, and its prevalence has increased in recent years. Both individual and family QoL is seriously threatened by the presence of food allergies, which carry personal and societal costs. Understanding the diagnostic features of this condition is necessary for proper management of patients, prescription of an elimination diet, determining the optimal timing for an oral provocation test and expanding a diet. It is essential to know the diagnostic criteria to prevent overdiagnosis, reduce unnecessary restrictions, maintain breastfeeding or select the correct breast milk substitutes. The first step in management of food allergies is establishing an accurate diagnosis based on the clinical picture and exclusion of foods that may cause allergic reactions, most often cow's milk. This process is associated with difficulties and risks for nutrition; therefore, it requires special attention. The article presents a clinical case report of a patient (a girl aged 2 months) with complaints of a rash all over her body, predisposition to constipation, and breast refusal. The symptoms of food allergies and principles of diet and therapy are described in detail. The management of food allergies includes diagnostic algorithms in combination with the development of an individual nutrition plan and timely assessment of tolerance. All these measures are aimed at reducing the load on the body and minimizing the risks associated with nutrition.

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The authors declare that there are no conflicts of interest present.