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牛奶蛋白过敏致婴儿食物诱导性小肠结肠炎综合征1 例报告

  • 方铁夫 ,
  • 龚四堂 ,
  • 陈佩瑜 ,
  • 许朝晖 ,
  • 梁翠萍 ,
  • 何婉儿 ,
  • 杨敏 ,
  • 耿岚岚 ,
  • 李慧雯
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  • 广州市妇女儿童医疗中心消化科( 广东广州 510623)

收稿日期: 2014-11-15

  网络出版日期: 2014-11-15

Food protein-induced enterocolitis syndrome caused by cow's milk protein allergy in an infant: case report and review of literature

  • Fang Tiefu ,
  • Gong Sitang ,
  • Chen Peiyu ,
  • Xu Zhaohui ,
  • Liang Cuiping ,
  • He Waner ,
  • Yang Min ,
  • Geng Lanlan ,
  • Li Huiwen
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  • Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou 510623,Guangdong, China

Received date: 2014-11-15

  Online published: 2014-11-15

摘要

 目的 探讨牛奶蛋白过敏及牛奶蛋白过敏导致的食物诱导性小肠结肠炎综合征的临床诊断和治疗。方法 回顾性分析1例牛奶蛋白过敏导致婴儿食物诱导性小肠结肠炎综合征的临床资料。结果 出生67 d女性患儿,出生起即混合喂养,出生后2周起反复腹泻、腹胀、呕吐、黏液血便、喂养困难、贫血和生长发育迟缓。实验室检查见贫血、白细胞总数和C反应蛋白升高、嗜酸性粒细胞比例增高,牛奶特异性IgE阴性。4次住院及入院时均诊断为“坏死性小肠结肠炎”。经回避牛奶蛋白4周后,症状消失,牛奶蛋白激发试验阳性,符合牛奶蛋白过敏以及牛奶蛋白过敏导致婴儿食物诱导性小肠结肠炎特征。结论 牛奶蛋白过敏及牛奶蛋白过敏导致婴儿食物诱导性小肠结肠炎的临床表现非特异性,症状体征多样,临床需注意辨别。

本文引用格式

方铁夫 , 龚四堂 , 陈佩瑜 , 许朝晖 , 梁翠萍 , 何婉儿 , 杨敏 , 耿岚岚 , 李慧雯 . 牛奶蛋白过敏致婴儿食物诱导性小肠结肠炎综合征1 例报告[J]. 临床儿科杂志, 2014 , 32(11) : 1072 . DOI: 10.3969 j.issn.1000-3606.2014.11.018

Abstract

To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding difficulty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-specific IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of “necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein rechallenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-specific and variable clinical symptoms and signs, and should be considered in the differential diagnosis.
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