Food allergy in children: diagnosis and treatment with sodium cromoglycate

Abstract

Food allergy (FA) is a very important problem affecting numbers of infants and children with protean manifestations which are frequent challenges to the pediatrician and other specialists working with children. Adverse reactions to food are very complex, frequently mediated bu IgE mechanisms, and often by other mechanisms. To make the correct diagnosis and to arrive at a proper therapeutic approach requires all the skill a physician can gather. Only an extensive knowledge of the various mechanisms and pharmacologic agents that can be used to prevent or treat these adverse reactions will allow the physician to approach the problem scientifically and come to a reasonable solution for the patient. The role of dietary factors in atopic dermatitis (AD) has long been a subject of controversies. However, it has been shown that FA plays a role in some children with AD. Therefore, the management of this multifaceted disorder is a challenge for pediatricians, dermatologists, and allergists. SCG, which is the salt of a bis-chromone carboxylic acid, has been shown to be of proven efficacy in the prophylaxis of bronchial asthma, allergic rhinitis, and of other disorders associated with mast cell degranulation. The drug has different modes of action, such as inhibition of rat passive cutaneous anaphylaxis, and the antigen-induced histamine release from passively sensitized peritoneal cells. Recently, clinical studies indicated that SCG has a direct effect on inflammatory cells, inhibiting either various leukocyte functions (membrane receptor expression, cytotoxic capacity), or "in vitro" activation of human neutrophils, eosinophils and monocytes. Although SCG has been widely used for the management of respiratory allergy, conflicting results of FA treatment have been reported by several authors. We have reviewed 18 papers on the use of SCG in the management of children with FA, which included 341 children aged 0.5-15 years. In this paper we discuss 12 studies reporting 281 children affected with AD.