title: Food hypersensitivity and otolaryngologic conditions in young children.
abstract: OBJECTIVE
  To explore the relationship between food hypersensitivity and common upper aerodigestive disorders found in children younger than 2 years.
  
  
  METHODS
  Case control study.
  
  
  METHODS
  Tertiary pediatric gastroenterology/otolaryngology clinics.
  
  
  METHODS
  Two-year retrospective chart review of a common cohort of children younger than 2 years with suspected cow's milk protein allergy (CMPA). Patients were managed in both a tertiary pediatric gastroenterology and otolaryngology clinic and compared with a control study group.
  
  
  RESULTS
  One hundred ninety-one children with CMPA were reviewed. One hundred forty-one had aerodigestive complaints, with 101 having sufficient follow-up to participate in the study. Ninety-one percent of this final patient group demonstrated improved symptoms following dairy elimination. Twenty-five patients (27%) had associated otolaryngologic (ear, nose, and throat [ENT]) issues that had been refractory to maximal gastroesophageal reflux therapy. The most common associated upper aerodigestive conditions were persistent upper airway congestion (72%) and oropharyngeal dysphagia (80%). Sixty percent of ENT disease improved with elimination diet. Eosinophilic esophagitis was noted in 36% of the cohort who had mucosal biopsies performed. Otolaryngology intervention was much more common in the cohort of children with CMPA compared with controls (odds ratio, 33.78; 95% confidence interval, 7.55, 151.03).
  
  
  CONCLUSIONS
  CMPA is difficult to diagnose because of limited accurate diagnostic tools, especially in young children. This study suggests a relationship between CMPA and otolaryngologic conditions in children younger than 2 years. Some patients in this study showed symptom improvement via an elimination diet. Early recognition of otolaryngologic manifestations of CMPA may help manage this condition in young children.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas 72205, USA. acpaddack@uams.edu
authors.forename: Angela
authors.initials: A
authors.lastname: Paddack
authors.forename: Troy
authors.initials: T
authors.lastname: Gibbons
authors.forename: Chandra
authors.initials: C
authors.lastname: Smith
authors.forename: Sowmya
authors.initials: S
authors.lastname: Patil
authors.forename: Gresham T
authors.initials: GT
authors.lastname: Richter
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications* / Q000209:etiology*; D008894:Milk Proteins / Q000009:adverse effects* / Q000276:immunology; D010038:Otorhinolaryngologic Diseases / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D008894:Milk Proteins