Allergic colitis presenting in the first day of life: report of three cases

D Kumar1, A Repucci, J Wyatt-Ashmead

  • 1Department of Pediatrics, MetroHealth Medical Center, Cleveland, Ohio, USA.

Insights

Allergic colitis in newborns presents with hematochezia and requires excluding other causes. Diagnosis involves infant appearance and specific tests, with treatment focused on antigen removal.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Immunology

Background:

  • Allergic colitis is a potential cause of hematochezia in newborns.
  • It should be considered in the differential diagnosis of neonates presenting with rectal bleeding.

Observation:

  • Affected infants typically appear healthy.
  • Diagnosis is supported by proctosigmoidoscopy and histopathology.
  • Exclusion of infectious and anatomic disorders is crucial.

Findings:

  • Infants with allergic colitis often respond to antigen withdrawal.
  • Hydrolyzed cow's milk protein or elemental formulas are effective.
  • For breastfed infants, maternal dietary antigen elimination is key.

Implications:

  • Early diagnosis and management of allergic colitis improve infant outcomes.
  • Dietary modifications are the cornerstone of treatment.
  • Understanding allergic colitis is vital for neonatal care.

Related Concept Videos

Allergic Reactions02:06

Allergic Reactions

Overview
Development of Immunocompetence01:22

Development of Immunocompetence

The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...