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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
[Clinical characteristics of infants with allergic proctocolitis: a retrospective study of 96 cases]
Hong-Mei Zhao1, Jie-Yu You, Bin Xu
1Department of Gastroenterology, Hunan Children's Hospital, Changsha 410007, China. yjy6601@sina.com.
Insights
Infants with allergic proctocolitis often present with diarrhea. Early diagnosis relies on colonoscopy and biopsy, with avoidance of allergens being the primary treatment.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Clinical Medicine
Context:
- Allergic proctocolitis is a significant cause of lower gastrointestinal distress in infants.
- Diagnosis can be challenging due to non-specific clinical manifestations.
- Understanding clinical characteristics is crucial for timely intervention.
Purpose:
- To characterize the clinical features of hospitalized infants diagnosed with allergic proctocolitis.
- To establish a foundation for improved early diagnosis and effective treatment strategies.
- To analyze diagnostic findings from electronic colonoscopy and histopathology.
Summary:
- Diarrhea was the most common symptom in 96 infants with allergic proctocolitis.
- Colonoscopy revealed mucosal abnormalities including nodules, erythema, erosion, and ulcers, predominantly in the sigmoid colon and rectum.
- Histopathology confirmed eosinophilic infiltration, aiding in diagnosis. Dietary allergen avoidance, including hydrolyzed or amino acid-based formulas, led to complete remission.
Impact:
- Highlights the utility of colonoscopy and biopsy in diagnosing infant allergic proctocolitis.
- Provides evidence-based recommendations for dietary management in formula-fed infants.
- Aims to improve clinical outcomes and reduce diagnostic delays for this condition.
Objective:
To study the clinical characteristics of hospitalized infants with allergic proctocolitis, and to provide a scientific basis for early diagnosis and effective treatment of allergic proctocolitis.
Methods:
The clinical data of 96 infants with allergic proctocolitis between September 2011 and March 2013 were reviewed retrospectively. Descriptive analysis was performed to assess the clinical characteristics of allergic proctocolitis.
Results:
The most common clinical manifestation was diarrhea in the 96 infants. The electronic colonoscopy results indicated that 40% of the infants had multiple small nodules, 26% showed focal erythema and brittle mucous membranes, 25% showed multiple superficial erosion, and 9% showed ulcers with surface exudates. The affected areas included the sigmoid colon (87%), rectum (24%), descending colon (13%), and transverse colon ascending colon and ileocecal junction (8%). Histopathologic examination showed eosinophilic infiltration of mucosal layers, the condition of which was mild to moderate in 89% and severe and extremely severe in 12% of the infants. To treat the allergic proctocolitis, mothers and infants were suggested to avoid allergenic foods; 43% of them continued breastfeeding, 45% switched to highly hydrolyzed protein formula, and 13% were prescribed amino acid-based elemental formula. All infants were in complete remission at discharge.
Conclusions:
As the clinical manifestations of allergic proctocolitis in infants lack specificity, the electronic colonoscopy and mucosal histopathologic examination are helpful for early and differential diagnosis. The best treatment is to avoid allergenic foods. Formula-feeding infants should be prescribed highly hydrolyzed protein formula or amino acid-based elemental formula.
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