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Eosinophilic colitis in infants
Adriana Chebar Lozinsky1, Mauro Batista de Morais1
1Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Insights
Eosinophilic colitis, primarily affecting male infants under six months, is often caused by cow's milk allergy. Dietary exclusion of cow's milk protein is an effective treatment for this condition.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
Background:
- Eosinophilic colitis is a rare gastrointestinal disorder characterized by eosinophilic infiltration of the colon.
- It predominantly affects infants and is often associated with food allergies.
Purpose of the Study:
- To conduct a literature review of clinical data concerning infants diagnosed with allergic or eosinophilic colitis.
- To identify the characteristics, causes, and effective management strategies for eosinophilic colitis in infants.
Main Methods:
- A comprehensive MEDLINE search was performed using keywords related to allergic and eosinophilic colitis.
- Articles published between 1966 and February 2013 describing patient characteristics were selected for review.
Main Results:
- The review included 32 articles detailing 314 infants, with 61.6% being male and 78.6% under six months old.
- Cow's milk protein was identified as a common trigger (44.2% of cases), with eosinophilia confirmed in 43.8% of infants.
- Dietary elimination of cow's milk protein led to improvement in most patients.
Conclusions:
- Eosinophilic colitis is most common in males within the first six months of life.
- Cow's milk allergy is considered the primary etiology.
- Excluding cow's milk from the infant's or lactating mother's diet is a generally effective therapeutic approach.
Objective:
To review the literature for clinical data on infants with allergic or eosinophilic colitis.
Data Source:
MEDLINE search of all indexes was performed using the words "colitis or proctocolitis and eosinophilic" or "colitis or proctocolitis and allergic" between 1966 and February of 2013. All articles that described patients' characteristics were selected.
Data Synthesis:
A total of 770 articles were identified, of which 32 met the inclusion criteria. The 32 articles included a total of 314 infants. According to the available information, 61.6% of infants were male and 78.6% were younger than 6 months. Of the 314 patients, 49.0% were fed exclusively breast milk, 44.2% received cow's milk protein, and 6.8% received soy protein. Diarrheal stools were described in 28.3% of patients. Eosinophilia was found in 43.8% (115/263) of infants. Colonic or rectal biopsy showed infiltration by eosinophils (between 5 and 25 per high-power field) in 89.3% (236/264) of patients. Most patients showed improvement with the removal of the protein in cow's milk from their diet or the mother's diet. Allergy challenge tests with cow's milk protein were cited by 12 of the 32 articles (66 patients).
Conclusions:
Eosinophilic colitis occurs predominantly in the first six months of life and in males. Allergy to cow's milk was considered the main cause of eosinophilic colitis. Exclusion of cow's milk from the diet of the lactating mother or from the infant's diet is generally an effective therapeutic measure.
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