Challenges in diagnosing non-IgE dependent food allergy in infants

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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