Bloody stool in infants with gastrointestinal manifestations of cow milk protein allergy, any significance?

https://doi.org/10.53730/ijhs.v6nS7.12910

Authors

  • Yasser K. Rashed Associate Professor Department of Pediatric Hepatology, Gastroenterology, and Nutrition - National Liver Institute, Menoufiya University- Egypt. IRB00003413, 32511 Shebin El-koom, Menoufia, Egypt. Fax: +2-048-223-4586; Tel.: +2-048-222-2740
  • Amal Sherif Department of Pediatrics - Al Qassimi Women and Children Hospital- Sharjah- UAE
  • Aysha Shattaf Department of Pediatrics - Al Qassimi Women and Children Hospital- Sharjah- UAE
  • Subaiha Alteneiji Department of Pediatrics - Al Qassimi Women and Children Hospital- Sharjah- UAE
  • Yamen Elmoghany Department of Pediatrics - Al Qassimi Women and Children Hospital- Sharjah- UAE
  • Ahmed Ismail Department of Pediatrics - Al Qassimi Women and Children Hospital- Sharjah- UAE

Keywords:

Bloody stool, Cow milk allergy, Allergic colitis

Abstract

Background: Cow milk protein (CMP) is the most common cause of food allergy in infants and young children. CMP allergy (CMPA) can affect more than one system, such as the skin, respiratory, or digestive systems.  Gastrointestinal tract manifestations are nonspecific. One of the most important GI manifestations of CMPA is bloody stool. Purpose: This study aims to describe how many infants with GI manifestations of CMPA presented with bloody stool as it was a very annoying symptom to the family and describe how can be managed adequately. Methods: This study included 100 patients with gastrointestinal manifestations of CMPA, their ages ranged from 8 weeks to 2 years.  52 males and 48 females. All study patients were subjected to complete history, thorough clinical examination, imaging necessary, and laboratory investigations Results: bloody diarrhea was recorded in 23 patients, and 2 of them were diagnosed with food protein-induced enterocolitis syndrome (FPIES). Occult blood was detected in 11 patients in the diarrhea group (33.33%), 17 patients in the GER group (47.2%), and was detected in 5 patients (83.33%) who presented constipation associated with massive abdominal distension. 

Downloads

Download data is not yet available.

References

Venter C, Pereira B, Voigt K, Grundy J, Clayton CB, Higgins B, et al: Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life. Allergy 2008, 63(3):354–359.

Fiocchi A, Brozek J, Schunemann H, Bahna SL, von BA, Beyer K, et al: World Allergy Organization (WAO) diagnosis and rationale for action against Cow's milk allergy (DRACMA) guidelines. World Allergy Organ J 2010, 3(4):57–161.

Bhanu Pillai R and Vasundhara Tolia. Gastrointestinal bleeding in infants and children. Therapy (2008) 5(4), 465–473

Arvola T, Ruuska T, Keranen J, et al. Rectal bleeding in infancy: clinical, allergological, and microbiological examination. Pediatrics 2006;117:e760–8.

Savage, J.; Johns, C.B. Food allergy: Epidemiology and natural history. Immunol. Allergy Clin. N. Am. 2015, 35, 45–59.

Jarungchit Ngamphaiboon, Pantipa Chatchatee and Thaneya Thongkaew. Cow’s Milk Allergy in Thai Children. ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY (2008) 26: 199-204

Boettcher, E.; Crowe, S.E. Dietary proteins and functional gastrointestinal disorders. Am. J. Gastroenterol. bn2013, 108, 728–736.

Host A. Frequency of cow’s milk allergy in childhood. Ann Allergy Immunol 2002;89(Suppl 1):33–7.

Vanto T, Juntunen-Backman K, Kalimo K, Klemola T, Koivikko A, Koskinen P, Syvanen P, Valovirta E, Varjonen E. The patch test, skin prick test, and serum milk-specific IgE as diagnostic tools in cow's milk allergy in infants. Allergy. 1999 Aug;54:837-42.

Morton RE, Nysenbaum A, Price K. Iron status in the first year of life. J Pediatr Gastroenterol Nutr 1988;7:707-12.

Mehr S, Frith K, Barnes E, Campbell D; FPIES Study Group. Food protein-induced enterocolitis syndrome in Australia: a population-based study, 2012-2014. J Allergy Clin Immunol. 2017;140(5):1323-30.

Koletzko S., Niggemann B., Arato A. , Vandenplas Y. Diagnostic Approach and Management of Cow’s-Milk Protein Allergy in Infants and Children: ESPGHAN GI Committee Practical Guidelines. JPGN 2012;55: 221–229.

Ahrens B, Lopes de Oliveira LC, Schulz G, Borres MP, Niggemann B, Wahn U, et al. The role of hen’s egg-specific IgE, IgG and IgG4 in the diagnostic procedure of hen’s egg allergy. Allergy 2010;65:1554e7.

Published

21-09-2022

How to Cite

Rashed, Y. K., Sherif, A., Shattaf, A., Alteneiji, S., Elmoghany, Y., & Ismail, A. (2022). Bloody stool in infants with gastrointestinal manifestations of cow milk protein allergy, any significance?. International Journal of Health Sciences, 6(S7), 4456–4464. https://doi.org/10.53730/ijhs.v6nS7.12910

Issue

Section

Peer Review Articles

Most read articles by the same author(s)