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Neonatal enteropathies: defining the causes of protracted diarrhea of infancy

Philip M Sherman1, David J Mitchell, Ernest Cutz

  • 1Research Institute, Hospital for Sick Children, University of Toronto, Ontario, Canada. sherman@sickkids.ca

Journal of Pediatric Gastroenterology and Nutrition
|December 17, 2003
PubMed

Insights

Chronic diarrhea in infants is often caused by infections or food sensitivities. This review focuses on neonatal enteropathies like microvillus inclusion disease, characterized by villus blunting.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Medicine
  • Gastrointestinal Pathology

Background:

  • Chronic diarrhea in early life has defined causes, primarily infectious/post-infectious and food-sensitive enteropathies.
  • Protracted diarrhea in infants and young children necessitates characterization of specific underlying entities.
  • Disorders of intestinal ion transport typically manifest at birth, often with polyhydramnios, and show normal villus architecture.

Purpose of the Study:

  • To review defined neonatal enteropathies causing protracted diarrhea in infants and young children.
  • To differentiate neonatal enteropathies from disorders of intestinal ion transport based on histopathology.
  • To focus on conditions characterized by villus blunting in neonatal enteropathies.

Main Methods:

  • Review of existing literature on neonatal enteropathies and chronic diarrhea.
  • Histopathological comparison of neonatal enteropathies versus intestinal ion transport disorders.
  • Characterization of key features of specific neonatal enteropathies.

Main Results:

  • Neonatal enteropathies are histopathologically distinct from ion transport disorders, showing villus blunting versus normal architecture.
  • Key neonatal enteropathies discussed include microvillus inclusion disease, tufting enteropathy, autoimmune enteropathy, and IPEX syndrome.
  • These conditions represent significant causes of chronic diarrhea in neonates and young children.

Conclusions:

  • Neonatal enteropathies, defined by villus blunting, are a critical focus for understanding early-life chronic diarrhea.
  • Accurate diagnosis of these conditions is essential for appropriate management.
  • Further research into the specific mechanisms and treatments for these enteropathies is warranted.

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