IgE-Dependent Food Sensitisation and Its Role in Clinical and Laboratory Presentation of Paediatric Inflammatory Bowel Disease

The rising prevalence of inflammatory bowel disease (IBD) and food allergies and their partially overlapping mechanisms such as microbiome diversity reduction raise questions about the role of allergies in IBD. While data on their comorbidity are available, analysis of IgE-sensitization's influence on the clinical presentation of IBD is lacking and is the aim of this study. Histories of 292 children with newly diagnosed IBD (173 cases of ulcerative colitis, 119 cases of Crohn's disease) were analyzed. Disease age of onset, activity, location, behaviour, and anthropometric and laboratory parameters were tested for its dependence on the presence of chosen IgE sensitization markers. A.o. Chi2, OR and phi coefficient were assessed. In Crohn's disease (CD), elevated total IgE (tIgE) correlated with weight loss, rectal bleeding, ASCA IgG positivity (phi = 0.19 for all) and negatively correlated with complicated disease behaviour (phi = -0.19). TIgE > 5 x reference range correlated with being underweight (phi = 0.2), ASCA IgG positivity (phi = 0.3), ASCA double (IgA and IgG) positivity (phi = 0.25) and elevated total IgG (phi = 0.18). The presence of specific IgEs (sIgE) correlated with extraintestinal manifestations of IBD (phi = 0.19): Egg white sIgE correlated with upper GI involvement (L4b) (phi = 0.26), severe growth impairment (phi = 0.23) and colonic mucosal eosinophilia (phi = 0.19). In ulcerative colitis, decreased IgA correlated with egg white sIgE (phi = 0.3), as well as the presence of any (phi = 0.25) or multiple sIgEs (phi = 0.2); the latter correlated also with elevated IgG (phi = 0.22), fever (phi = 0.18), abdominal pain (phi = 0.16) and being underweight (phi = 0.15). Cow's milk sIgE correlated positively with growth impairment (phi = 0.15) and elevated IgG (phi = 0.17) and negatively with extensive colitis (phi = -0.15). Pancolitis correlated negatively with sIgE presence (phi = -0.15). In summary, single moderate and numerous weak but interesting relationships were observed.

Automated summary

This study analyzed the medical history of 292 newly diagnosed pediatric IBD patients and found that IgE sensitization is related to the clinical presentation of IBD, including disease behavior, nature, and certain laboratory parameters.