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[Eosinophilic colitis caused by allergy to cow's milk protein]
M Rossel1, S Ceresa, J Las Heras
1Departamento de Pediatría, Facultad de Medicina, Universidad de Chile.
Insights
Eosinophilic colitis in infants is often linked to cow's milk allergy. Removing milk from the diet resolved rectal bleeding in all cases, with some infants tolerating milk later on.
Area of Science:
- Pediatric Gastroenterology
- Allergy Immunology
Context:
- Eosinophilic colitis is a recognized allergic reaction to cow's milk in infants.
- Early diagnosis and dietary management are crucial for allergic conditions in the first year of life.
Purpose:
- To report a series of infants diagnosed with eosinophilic colitis.
- To analyze the clinical presentation, dietary management, and challenge outcomes in these patients.
Summary:
- Nine infants under nine months presented with rectal bleeding, with or without diarrhea, shortly after cow's milk formula initiation or, in some cases, while exclusively breastfed.
- Rectal bleeding resolved in all infants upon withdrawal of cow's milk from the diet.
- Follow-up challenges after 12 months showed varied tolerance, with some infants able to consume milk while others continued to react.
Impact:
- Highlights the significance of cow's milk allergy as a cause of eosinophilic colitis in infants.
- Demonstrates the efficacy of milk withdrawal in managing symptoms.
- Suggests a trend of increasing early-life allergy diagnoses, emphasizing the need for awareness and timely intervention.
Abstract:
Eosinophilic colitis is one of the clinical manifestations of allergy to cow's milk during the first year of life. We report a series of 9 infants who, under 9 months of age and while clinically well, presented rectal bleeding of variable magnitude, with or without diarrhea, shortly after a cow's milk-based formula was initiated (n = 6); yet, 3 cases received only breast feeding. Bleeding disappeared in all patients after milk withdrawal from the diet. Challenges were planned after 12 months of treatment; three patients have not yet reached this moment, 3 had a negative challenge at 12, 18 and 28 months of age and are on a complete diet, and 3 are still on cow's milk free diet because ingestion of milk at 12, 18 and 25 months still induced rectal bleeding. This series of patients gathered in 3 years, follows the trend reported in many countries that there is a relative increase of patients diagnosed with allergy conditions early in life.