44
Abstracts
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
Pediatrics
Histamine Intolerance as a Cause of Chronic
Digestive Complaints in Pediatric Patients
Rosell-Camps A, et al
Rev Esp Enferm Dig
. 2013;105(4):201–207.
Histamine intolerance (HI) is a poorly described disease
in gastroenterology that may present with predominant
digestive complaints. The goals of this study include a
report of 2 cases diagnosed in a pediatric gastroenterology
clinic.
It is an observational, retrospective study of patients
diagnosed with HI at the pediatric gastroenterology clinic
of a tertiary hospital. They were deemed to have a diagnosis
of HI in the presence of 2 or more characteristic digestive
complaints, decreased diamino oxidase (DAO) levels and/
or response to a low histamine diet with negative IgE-
mediated food allergy tests.
Sixteen patients were diagnosed—predominant symptoms
included diffuse abdominal pain (16/16), intermittent
diarrhea (10/16), headache (5/16), intermittent vomiting
(4/16), and skin rash (2/16). The diagnosis was established
by measuring plasma DAO levels, which were below
10 kU/L in 14 cases and symptom clearance on initiating a
low histamine diet. In 2 patients DAO levels were above
10 kU/L but responded to diet. Treatment was based on a
diet low in histamine-contaning food, and antihistamines
H1 and H2 had to be added for 2 cases.
Predominant complaints include diffuse abdominal pain,
diarrhea, headache, and chronic intermittent vomiting.
Its diagnosis is based on clinical suspicion, plasma DAO
measurement, and response to a low histamine diet.
Diarrhea in Early Childhood: Short-term
Association With Weight and Long-term
Association With Length
Richard SA, et al
Am J Epidemiol
. 2013;178(7):1129–1138.
The short-term association between diarrhea and weight
is well-accepted, but the long-term association between
diarrhea and growth is less clear. Using data from 7
cohort studies (Peru, 1985–1987; Peru, 1989–1991; Peru,
1995–1998; Brazil, 1989–1998; Guinea-Bissau, 1987–1990;
Guinea-Bissau, 1996–1997; and Bangladesh, 1993–1996),
we evaluated the lagged relationship between diarrhea and
growth in the first 2 years of life.
Our analysis included 1,007 children with 597,638
child-days of diarrhea surveillance and 15,629
anthropometric measurements. We calculated the
associations between varying diarrhea burdens during
lagged 30-day periods and length at 24 months of age.
The cumulative association between the average diarrhea
burden and length at age 24 months was - 0.38 cm (95%
CI = - 0.59, - 0.17). Diarrhea during the 30 days prior to
anthropometric measurement was consistently associated
with lower weight at most ages, but there was little
indication of a short-term association with length. Diarrhea
was associated with a small but measurable decrease in
linear growth over the long term.
These findings support a focus on prevention of diarrhea as
part of an overall public health strategy for improving child
health and nutrition; however, more research is needed to
explore catch-up growth and potential confounders.
