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Endoscopy and allergy cow milk protein

Sara Ebrahimi, Gholamreza Khademi, Seyed Ali Jafari, Nona Zaboli Nejad, Abdolreza Norouzy, Bahareh Imani
Very-early-onset inflammatory bowel disease (VEO-IBD) has a distinct phenotype and should be considered a specific entity. VEO-IBD presents with very severe clinical pictures and is frequently known by an indeterminate colitis whose clinical remission is unmanageable. This study examines the case of a neonate with VEO-IBD, not responding to medical and surgical treatment. A 7-day-old Iranian female neonate presented with severe bloody diarrhea, poor feeding, abdominal distention, and dehydration suggesting severe proctocolitis due to an allergy to the protein in cow's milk...
May 2018: Iranian Journal of Medical Sciences
Cristina Oana Mărginean, Lorena Elena Meliţ, Vlăduţ Stefănuţ Săsăran, Cristian Dan Mărginean, Maria Oana Mărginean
RATIONALE: Celiac disease is a chronic, immune-mediated, multiorgan disorder that affects susceptible individuals, and it is triggered by gluten and other prolamins. PATIENT CONCERNS: We present the case of a 1-year-old male child, with a history of idiopathic pericardial effusion, admitted in our clinic for severe abdominal bloating, irritability, loss of appetite and intermittent diarrheic stools. The clinical findings were: influenced general status, irritability, distended abdomen, and diffuse abdominal tenderness...
June 2018: Medicine (Baltimore)
Fu-Ping Lai, Yao-Jong Yang
BACKGROUND: The clinical presentation of cow's milk protein allergy (CMPA) in children varies. This retrospective study aimed to investigate the prevalence and clinical manifestations of CMPA in young children who visited for evaluation of iron deficiency anemia (IDA). METHODS: Patients aged <4 years who were diagnosed as having IDA (serum ferritin <12 ng/mL) at the National Cheng Kung University Hospital, Taiwan in the period 2005-2015 were reviewed. Their clinical presentations, laboratory data, endoscopy findings, and prognosis were analyzed...
February 2018: Pediatrics and Neonatology
Mieczysława Czerwionka-Szaflarska, Ewa Łoś-Rycharska, Julia Gawryjołek
The gastrointestinal form of food allergy is very common in children. The most frequently observed types are allergic proctitis and proctocolitis. In most cases the symptoms subside within the first 2 months of life. The babies seem healthy, and the only abnormality is a small amount of blood in stool. Symptoms can also include small intestine inflammation and colitis. Patients may present with irritability, abdominal pain, flatulence, colic, postprandial vomiting, chronic diarrhoea, and hindered physical development...
2017: Przegla̜d Gastroenterologiczny
R Cervantes-Bustamante, I Pedrero-Olivares, E M Toro-Monjaraz, P Murillo-Márquez, J A Ramírez-Mayans, E Montijo-Barrios, F Zárate-Mondragón, J Cadena-León, M Cazares-Méndez, M López-Ugalde
BACKGROUND: Cow's milk protein allergy is the most common cause of food allergy. The challenge test, either open or doubled-blind with a placebo control, is regarded as the criterion standard. Endoscopy and histologic findings are considered a method that can aid in the diagnosis of this entity. AIMS: The aim of this study was to describe the histopathologic findings in children suspected of cow's milk protein allergy that were seen at our hospital. MATERIAL AND METHODS: A descriptive, observational study was conducted on 116 children clinically suspected of presenting with cow's milk protein allergy that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría...
April 2015: Revista de Gastroenterología de México
Manal Mohamed Zaher, Eman Mohamed Ahmed, Amal Abd El Alim Morsy
Cow's milk protein allergy (CMPA) is common in infants with variable clinical presentation including varied gastrointestinal manifestation. Cow's milk protein allergy chiefly, involving occurs in children below the age of 3 years, successful therapy depends on completely eliminating cow's milk proteins (CMP) from the child's diet. Ideally, with the replacement of hypo or an allergenic food. Symptoms suggestive of CMPA may be encountered in approximately 5 to 15% of infants emphasizing the importance of controlled elimination/milk challenge procedures...
2014: Egyptian Journal of Immunology
Cristina Targa Ferreira, Elisa de Carvalho, Vera Lucia Sdepanian, Mauro Batista de Morais, Mário César Vieira, Luciana Rodrigues Silva
OBJECTIVE: there are many questions and little evidence regarding the diagnosis and treatment of gastroesophageal reflux disease (GERD) in children. The association between GERD and cow's milk protein allergy (CMPA), overuse of abdominal ultrasonography for the diagnosis of GERD, and excessive pharmacological treatment, especially proton-pump inhibitors (PPIs) are some aspects that need clarification. This review aimed to establish the current scientific evidence for the diagnosis and treatment of GERD in children...
March 2014: Jornal de Pediatria
Yvan Vandenplas
Paediatric GERD is complicated to manage, as symptoms are diverse and often difficult to interpret. In infants, regurgitation is a common physiological condition. Nevertheless, when it occurs frequently (>4 times per day) and causes the infant distress, parents often seek medical help. In children 2-10 years of age, GERD is often considered to cause extra-oesophageal symptoms, despite the absence of hard evidence. Diagnostic investigations often lack solid validation and the signs and symptoms of GERD overlap with those of cow's milk protein allergy and eosinophillic oesophagitis...
March 2014: Nature Reviews. Gastroenterology & Hepatology
Humam S Alabsi, Gary L Reschak, Nicholas J Fustino, Eduardo P Beltroy, Jacob E Sramek, Samir Y Alabsi
Rectal bleeding in neonates is an alarming sign that suggests a possible serious underlying condition, such as infection or bleeding disorder that would necessitate hospitalization and prompt intervention. We report a case of eosinophilic gastroenteritis caused by cow's milk protein allergy in a one-day- old infant, who presented with frankly bloody stools associated with massive gastrointestinal and peripheral blood eosinophilia prior to initiation of enteral feedings. The patient's outcome was favorable, with complete spontaneous recovery in one week, after a period of bowel rest, parenteral nutrition, and use of amino acid formula...
September 2013: Neonatal Network: NN
Ana Muñoz Urribarri, Alex Delgado Godos, Raúl Castillo Durán, Alejandro Yábar Berrocal
GOAL: Milk-based formulas can induce cow’s milk protein allergy (CMPA) in infants. This article discusses two cases of severe CMPA in infants exposed to casein-based formulas. CASES: Case N°1: A 7 day old boy developed diarrhea with no improvement despite several courses of antibiotic and switching to formula without lactose. At 2 months of age he had a hemoglobin 8.6 mg/dL, IgE = 17.8 IU/ml (normal <1.5 UI/ml) and a CD4/CD8 ratio = 0.16 (normal 1.5 – 2...
April 2011: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Odül Eğrıtaş, Sinan Sari, Buket Dalgiç, Aylar Poyraz, Arzu Ensarı
BACKGROUND/AIMS: Infantile persistent diarrhea series are not well documented in the literature. Evaluating the literature, the aim of this study was to document persistent diarrhea cases followed in our center and to constitute a practical diagnostic algorithm for the pediatrician by means of surveying methods. METHODS: Diarrheas lasting more than 14 days were accepted as persistent diarrhea. Forty-one persistent diarrhea cases aged 0-24 months were investigated in this study...
June 2011: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Sandra Lucarelli, Giovanni Di Nardo, Ginevra Lastrucci, Ylenia D'Alfonso, Adriana Marcheggiano, Tatiana Federici, Simone Frediani, Tullio Frediani, Salvatore Cucchiara
BACKGROUND: Allergic proctocolitis (APC) in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT) could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization...
2011: BMC Gastroenterology
Ujjal Poddar, Surender Kumar Yachha, Narendra Krishnani, Anshu Srivastava
AIM: The aim of this prospective study was to determine cow's milk protein allergy (CMPA) cases in a tertiary care hospital in India and to study its clinical presentations and outcome following treatment. METHODS: Consecutive children with chronic diarrhea from June 2004 to December 2007 were evaluated with hemogram, anti-endomysial antibody, upper gastrointestinal endoscopy, sigmoidoscopy and intestinal biopsies. Initial diagnosis of CMPA was based on characteristic intestinal biopsy (> 6 eosinophils/HPF) and diagnosis was confirmed by positive milk challenge...
January 2010: Journal of Gastroenterology and Hepatology
Elzbieta Jarocka-Cyrta, Andrzej Baniukiewicz, Jolanta Wasilewska, Joanna Pawlak, Maciej Kaczmarski
UNLABELLED: Patchy villous atrophy of duodenal mucosa has been described in young children with cow's milk allergy (CMA). Cow's milk protein-sensitive enteropathy may persist in older children and shows characteristic histological features. The advent of magnification endoscopy may allow the macroscopic detection of unrecognised villous atrophy in these patients. AIM: the aim of the study was to evaluate the duodenum mucosa in older children with CM A in infancy using chromoendoscopy and magnification endoscopy...
April 2007: Medycyna Wieku Rozwojowego
J Semeniuk, M Kaczmarski
PURPOSE: The hypothesis put forward in the current study was that food intolerance can be a cause of gastroesophageal reflux (GER) affecting children with this pathology at various age. In order to confirm or exclude this hypothesis, the study objective was to determine the frequency of the cause-and-effect relationship between allergy to cow milk proteins and/or other food products and gastroesophageal reflux found in the study group of patients, and to establish diagnostic differentiation guidelines in GER caused by food intolerance, i...
2006: Advances in Medical Sciences
P De Angelis, J E Markowitz, F Torroni, T Caldaro, A Pane, G Morino, R Sforza Wietrzykowska, G Federici di Abriola, A Ponticelli, L Dall'Oglio
UNLABELLED: Eosinophilic oesophagitis is an emerging disease, well known also in paediatric age, probably caused by both IgE and non-IgE mediated food allergies, diagnosed by upper endoscopy with biopsy. The most severe complication is oesophageal stenosis. The identification of the offending allergens is often difficult; therapy is focused to eliminate the supposed antigenic stimulus, to control the acute symptoms and to induce long-term remission. AIM: We report the clinical outcome and the typical endoscopic findings of children and adolescents affected by eosinophilic oesophagitis, referring a proposal of diagnostic and treatment protocol...
April 2006: Digestive and Liver Disease
Rodrigo Strehl Machado, Elisabete Kawakami, Soraya Goshima, Francy Reis Patrício, Ulysses Fagundes Neto
OBJECTIVE: To report two cases of infants with hemorrhagic gastritis due to cow's milk allergy. DESCRIPTION: The clinical features included hematemesis, vomiting and malnutrition. All patients had eosinophilic infiltrate in gastric biopsies and got favorable clinical outcome after cow's milk free diet. COMMENTS: Hemorrhagic gastritis due to cow's milk allergy is an uncommon diagnosis. Clinical findings in 10 patients (including ours) reported with allergic gastritis were vomiting, malnutrition, anemia, and hematemesis...
July 2003: Jornal de Pediatria
Phisek Yimyaem, Voranush Chongsrisawat, Boosba Vivatvakin, Naruemon Wisedopas
BACKGROUND: Cow's milk protein sensitive enteropathy (CMPSE) is a common condition in the first year of life. Clinically CMPSE usually presents with symptoms like vomiting, chronic diarrhea, mucous bloody diarrhea and hematemesis. More unusual symptoms associated with CMPSE are infantile colic, gastroesophageal reflux and chronic constipation. The objective of this study was to assess the gastrointestinal manifestations and allergic march in CMPSE patients. METHOD: The authors reviewed the records of 10 CMPSE patients observed by the Gastrointestinal Unit at King Chulalongkorn Memorial Hospital from 1997-2001 including patient characteristics, laboratory investigations, endoscopy and follow-up outcome...
February 2003: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Jorma Kokkonen, Sami Tikkanen, Tuomo J Karttunen, Erkki Savilahti
In previous studies, we have reported endoscopic and histological alterations locally on the gastrointestinal (GI) tract associated with a gastrointestinal type of cow's milk allergy. In this study, we sought to further characterize endoscopic, and immunological findings in these children. We also hypothesized that the same type of immune responses might also be found in children with unexplained and recurrent abdominal pains. We did a gastroduodenoscopy for persistent GI symptoms, examined the mucosal histology of the small intestine and measured the antibodies to whole cow's milk and its fractions with an enzyme-linked immunosorbent assay (ELISA) in a consecutive series of 22 subjects with untreated and 14 with treated cow's milk allergy (CMA) and 44 with recurrent abdominal pains (RAP)...
April 2002: Pediatric Allergy and Immunology
M Augustin, T J Karttunen, J Kokkonen
BACKGROUND: Variability of symptoms and signs make the diagnosis of children's food allergy (FA) difficult. In addition, mechanisms and antigens involved vary with age. In young infants, cow's milk protein allergy is associated with an increase of cytotoxic intraepithelial lymphocytes (IELs) expressing T-cell-restricted intracellular antigen (TIA1). In the current study, the significance of TIA1 in FA in older children of mainly preschool and school age was analyzed and the findings correlated the with a detailed clinical, endoscopic, and histopathologic analysis...
January 2001: Journal of Pediatric Gastroenterology and Nutrition
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