Palabras clave
Síndrome de enterocolitis inducida por proteínas alimentarias
Enfermedad celiaca
Proctocolitis alérgica
Anemia inducida por la leche de vaca
Enteropatía inducida por proteínas alimentarias
Síndrome de Heiner
Resumen
Antecedentes: La alergia alimentaria no mediada por IgE incluye reacciones adversas a alimentos mediadas por el sistema inmune innato e inmunidad celular. Se caracteriza por síntomas gastrointestinales subagudos o crónicos luego de la ingestión de algún alérgeno alimentario relevante, lo que dificulta el diagnóstico.
Objetivo: Revisar la bibliografía actualizada de los cuadros gastrointestinales por alergia alimentaria no mediada por IgE, que resuma la incidencia, fisiopatología, cuadro clínico, diagnóstico y tratamiento.
Métodos: Se realizó una búsqueda en las bases de datos Medline, EMBASE, Scielo, Google Académico y la red informática de medicina avanzada (RIMA) empleando las palabras clave: alergia alimentaria no mediada por IgE, proctocolitis alérgica; anemia inducida por leche de vaca; enteropatía inducida por proteínas alimentarias; síndrome de enterocolitis inducida por proteínas alimentarias; enfermedad celiaca y síndrome de Heiner. La búsqueda se limitó a artículos publicados en idioma inglés y español, de enero de 2015 a mayo de 2024.
Resultados: Aún con los avances en el reconocimiento de la alergia alimentaria no mediada por IgE, permanece incierta su prevalencia y fisiopatología. El sistema inmune innato y la inmunidad celular están implicados en la inflamación gastrointestinal; no obstante, se requieren estudios adicionales para esclarecer la inmunopatogénesis y biomarcadores asociados.
Conclusiones: Las alergia alimentaria no mediada por IgE representan una proporción desconocida de las alergias alimentarias. Puesto que no existen biomarcadores ni pruebas diagnóstica no invasivas, el tratamiento se establece por la sospecha clínica y se corrobora cuando los síntomas disminuyen, después de eliminar el alimento causante de la alergia entre 4 y 8 semanas. El tratamiento incluye la supresión en la dieta del alimento implicado, apoyo en caso de exposición accidental y asesoramiento nutricional.
Palabras clave: Alergia alimentaria no mediada por IgE; Síndrome de enterocolitis inducida por proteínas alimentarias; Enfermedad celíaca; Proctocolitis alérgica; Anemia inducida por leche de vaca; Enteropatía inducida por proteínas alimentarias; Síndrome de Heiner.
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