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Allergic colitis in infancy: clinical and pathologic aspects

H M Machida1, A G Catto Smith, D G Gall

  • 1Department of Pediatrics, University of Calgary, Alberta, Canada.

Journal of Pediatric Gastroenterology and Nutrition
|July 1, 1994
PubMed
Summary
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Rectal bleeding in infants is often caused by allergic colitis, characterized by eosinophilic inflammation. Dietary changes can resolve symptoms, suggesting an allergic basis for this common infant condition.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Allergy Immunology

Background:

  • Rectal bleeding in infants is a common concern.
  • Distinguishing benign causes from serious conditions is crucial.
  • Eosinophilic colitis is a potential, often overlooked, diagnosis.

Purpose of the Study:

  • To investigate the cause of fresh blood mixed with stools in otherwise healthy infants.
  • To evaluate the role of colonoscopy, biopsy, and laboratory markers in diagnosing infant colitis.
  • To explore the potential link between diet and eosinophilic colitis.

Main Methods:

  • Prospective evaluation of 35 infants with rectal bleeding.
  • Limited colonoscopy and biopsy in 34 infants.
  • Histopathological analysis for eosinophilic infiltrate and comparison with controls.

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Main Results:

  • 31 infants showed histopathological evidence of colitis with eosinophilic infiltrate.
  • Patients had higher eosinophil counts (peripheral and tissue) and lower serum albumin than controls.
  • Dietary changes led to rapid resolution of bleeding and improved serum albumin in 19 infants.

Conclusions:

  • Colitis with significant eosinophilic infiltrate is a common cause of rectal bleeding in infants.
  • Low serum albumin and high peripheral eosinophil counts suggest allergic colitis.
  • Dietary modification is effective, supporting an allergic etiology, though pathogenesis requires further study.