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Rectal mucosa in cows' milk allergy.
N Iyngkaran1, M Yadav, C G Boey
1Department of Paediatrics, University Hospital, Kuala Lumpur.
Archives of Disease in Childhood
|September 1, 1989
Summary
Diagnosing cows' milk protein sensitive enteropathy in infants can utilize rectal biopsies. Oral challenge with cow's milk protein can cause rectal injury in reactive infants, aiding diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Immunology
Background:
- Cows' milk protein sensitive enteropathy is a clinical concern in infants.
- Accurate diagnosis is crucial for appropriate management and preventing complications.
Purpose of the Study:
- To investigate the diagnostic utility of rectal biopsies in infants suspected of cows' milk protein sensitive enteropathy.
- To evaluate the correlation between oral cow's milk protein challenge and mucosal injury.
Main Methods:
- Eleven infants with suspected cows' milk protein sensitive enteropathy were fed a protein hydrolysate formula.
- Jejunal and rectal biopsies were performed before and 24 hours after oral cow's milk protein challenge.
- Clinical symptoms and mucosal alkaline phosphatase activity were assessed.
Main Results:
- Six infants (group 1) developed clinical symptoms and mucosal lesions (jejunal and rectal) after challenge.
- Rectal injury and depletion of alkaline phosphatase activity were observed in symptomatic infants.
- Five infants (group 2) showed no clinical or biopsy evidence of reaction.
Conclusions:
- Rectal mucosal injury following oral cow's milk protein challenge can serve as a diagnostic marker for cows' milk protein sensitive enteropathy.
- In some infants, cow's milk protein ingestion may affect the distal colon without impacting the proximal small intestine.