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Published on: April 10, 2019
[Allergic enterocolitis with protein-losing enteropathy in a 5-month-old girl: a case report]
Toru Watanabe1, Tatsuki Fukuie2, Iwao Tajima1
1Department of Pediatrics, Iwata City Hospital.
Insights
A 5-month-old infant with allergic enterocolitis experienced severe symptoms including vomiting and diarrhea. Dietary changes to an elemental formula successfully resolved the condition, highlighting the importance of identifying food triggers.
Area of Science:
- Pediatrics
- Gastroenterology
- Allergy Immunology
Background:
- Allergic enterocolitis is an emerging concern in infants, characterized by gastrointestinal inflammation.
- Protein-losing enteropathy can lead to significant nutritional deficiencies and edema in affected infants.
Observation:
- A 5-month-old infant presented with severe vomiting, diarrhea, edema, ascites, and bloody stools after a history of exclusive breastfeeding.
- Initial management with an elemental diet via enteral tube feeding led to temporary improvement, but symptoms recurred.
Findings:
- Endoscopic examination revealed inflammatory lesions from the cecum to the rectum.
- Biopsy confirmed eosinophilic enterocolitis, leading to a diagnosis of allergic eosinophilic enterocolitis.
- Resolution of symptoms and normal development were achieved after switching to a soybean-free elemental formula.
Implications:
- This case underscores the critical role of identifying specific food allergens, such as soy, in managing allergic enterocolitis.
- Early diagnosis and appropriate dietary interventions are crucial for improving outcomes in infants with this condition.
- Further research into the pathogenesis and management of allergic enterocolitis is warranted given its increasing prevalence.
Abstract:
We report the case of a 5-month-old female infant who had allergic enterocolitis with protein-losing enteropathy and had low birth weight. Until the age of 4 months, she was fed only breast milk and did not experience any related problems. When she was 5-months-old, she was admitted to our hospital with the chief complaints of vomiting and diarrhea. She had whole body edema, thoracic and abdominal ascites, and bloody stools. Laboratory examinations showed the presence of hypoalbuminemia, hypogammaglobulinemia, and an elevated CRP level. Subsequently, she was fed an elemental diet with enteral tube feeding, and her condition gradually improved. However, 2 weeks later, her symptoms reappeared, and therefore, she was admitted to the National Center for Child Health and Development. She underwent upper and colon endoscopies and was found out to have multiple inflammatory lesions in the area extending from the cecum to the rectum. The biopsy findings showed features of eosinophilic enterocolitis and she was diagnosed with allergic eosinophilic enterocolitis. Subsequently, an elemental formula that does not include soybean was used for feeding the infant. The symptoms resolved and her condition improved; currently, she is well and is showing normal development. We have reported this case because allergic enterocolitis is becoming a topic of concern.
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