Table 1

Major features of the 14 exclusively breast-fed infants with allergic proctocolitis

Patient

(sex)

Clinical Onset

Maternal elimination. diet (*)

Our observation

Atopy patch test

Endoscopic features

Histology Eosinophiles 10HPF (40x)

Current status (age)


Age (days)

Symptoms

Allergen avoidance

Duration

Age (days)

Symptoms

Baseline

Follow-up (**)

Baseline

Follow-up (**)


1 (F)

60

Haematochezia; GERD

CM

S

4 weeks

90

Severe rectal bleeding; syderopenic anemia

BM ++++

CM +

Scattered erosions; ileo-colonic LNH

Normal mucosa

> 60

Normal features

Free diet, well (by 3 years)


2 (M)

90

Haematochezia; GERD

CM

E

S

8 weeks

180

Melena; hematemesis

BM +++

CM ++

Diffuse erosions; ileal LNH

Mild LNH

> 60

Normal features

Free diet, well (by 2 years)


3 (M)

120

Chronic diarrhea

CM

E

6 weeks

160

Severe rectal bleeding

BM ++

S +

Scattered erosions; ileo-colonic LNH

Mild LNH

> 60

Normal features

Free diet, well (by 2 years)


4 (M)

10

Blood and mucus in stools

CM

E

S

3 weeks

30

Hematochezia

BM +++

CM +

E +

Friability; initial LNH

Normal mucosa

40-50

Normal features

CM and E-free diet (13 months)


5 (M)

20

Bloody diarrhea

CM

1 week

30

Bloody diarrhea; syderopenic anemia

BM ++

Scattered erosions; initial LNH

Normal mucosa

40-50

Normal features

Free diet, well (by 15 months)


6 (F)

20

Hematochezia; GERD

CM

S

9 weeks

120

Diarrhea; mucus in stools

BM +++

Diffuse LNH

Mild LNH

> 60

Normal features

CM and E-free diet (11 months)


7 (M)

7

Fluid diarrhoea and feeding refusal

CM

E

1 week

15

Hematochezia

CM ++

R +

Rectal erosions

Normal mucosa

40-50

Normal features

CM and R-free diet (7 months)


8 (M)

180

Haematochezia

CM

E

S

2 weeks

195

Severe rectal bleeding; dehydration

BM + CM ++ E ++ S ++ W + R ++

Diffuse LNH

Normal mucosa

> 60

Normal features

CM, S, E and R-free diet (15 months)


9 (F)

40

Blood and mucus in stools

CM

E

3 weeks

60

Hematochezia

BM ++++

Hedema; hyperhemia; scattered erosions

Normal mucosa

40-50

Normal features

CM and E-free diet (16 months)


10 (M)

28

Blood and mucus in stools; colics

CM

E

S

4 weeks

60

Bloody diarrhea; mucus in stools

BM ++

S ++

Diffuse erosions; ileo-colonic LNH

Normal mucosa

> 60

Normal features

Free diet, well (by 1 year)


11 (M)

30

Blood and mucus in stools; colics

CM

S

4 weeks

60

Severe rectal bleeding; colics

BM +++

CM +

Scattered erosions; friability; ileo-colonic LNH

Normal mucosa

40-50

Normal features

Free diet, well (by 1 year)


12 (F)

45

Diarrhea with mucus and blood; irritability

CM

E

S

6 weeks

60

Severe rectal bleeding

BM +++ CM + S +

Scattered erosions; ileo-colonic LNH

Mild LNH

40-50

Normal features

Free diet, well (by 1 year)


13 (M)

20

Blood and mucus in stools; colics

CM

1 week

30

Bloody diarrhea; mucus in stools

BM +

E +

Scattered erosions; friability ileo-colonic LNH

Normal mucosa

> 60

Normal features

CM and E-free diet (14 months)


14 (M)

21

Diarrhea with mucus and blood; irritability

CM

E

S

1 week

30

Bloody diarrhea; irritability

BM++

Diffuse erosions; ileal LNH

Normal mucosa

> 60

Normal features

Free diet, well (by 1 year)


(*) the diet was empirically administered by pediatricians before our observation; (**) after 30 days of exclusively elimination diet with amino acid-based formula; GERD = gastroesophageal reflux disease; HPF = high power field; LNH = lymphoid nodular hyperplasia; CM = cow's milk; E = egg; S = soy; W = wheat; R = rice; BM = breast milk.

Lucarelli et al. BMC Gastroenterology 2011 11:82   doi:10.1186/1471-230X-11-82

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