Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
권호 표지
DOI QR코드

DOI QR Code

Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?

  • Hwang, Jin-Bok (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Hong, Jeana (Department of Pediatrics, Kangwon National University Hospital)
  • 투고 : 2013.05.29
  • 심사 : 2013.08.28
  • 발행 : 2013.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for diagnosing suspected FPIPC in neonates is as follows. During the early stage, the etiology of small and fresh rectal bleeding in an otherwise healthy newborn need not be studied through extensive investigations. In patients showing continued bleeding even after 4 days, sigmoidoscopy and rectal mucosal biopsy may be performed. Even if mucosal histological findings indicate a diagnosis of FPIPC, further oral food elimination and challenge tests must be performed sequentially to confirm FPIPC. Food elimination and challenge tests should be included in the diagnostic criteria of FPIPC.

키워드

참고문헌

  1. Maloney J, Nowak-Wegrzyn A. Educational clinical case series for pediatric allergy and immunology: allergic proctocolitis, food protein-induced enterocolitis syndrome and allergic eosinophilic gastroenteritis with protein-losing gastroenteropathy as manifestations of non-IgE-mediated cow's milk allergy. Pediatr Allergy Immunol 2007;18:360-7. https://doi.org/10.1111/j.1399-3038.2007.00561.x
  2. Xanthakos SA, Schwimmer JB, Melin-Aldana H, Rothenberg ME, Witte DP, Cohen MB. Prevalence and outcome of allergic colitis in healthy infants with rectal bleeding: a prospective cohort study. J Pediatr Gastroenterol Nutr 2005;41:16-22. https://doi.org/10.1097/01.MPG.0000161039.96200.F1
  3. Odze RD, Bines J, Leichtner AM, Goldman H, Antonioli DA. Allergic proctocolitis in infants: a prospective clinicopathologic biopsy study. Hum Pathol 1993;24:668-74. https://doi.org/10.1016/0046-8177(93)90248-F
  4. Odze RD, Wershil BK, Leichtner AM, Antonioli DA. Allergic colitis in infants. J Pediatr 1995;126:163-70. https://doi.org/10.1016/S0022-3476(95)70540-6
  5. Winter HS, Antonioli DA, Fukagawa N, Marcial M, Goldman H. Allergy-related proctocolitis in infants: diagnostic usefulness of rectal biopsy. Mod Pathol 1990;3:5-10.
  6. Ohtsuka Y, Shimizu T, Shoji H, Kudo T, Fujii T, Wada M, et al. Neonatal transient eosinophilic colitis causes lower gastrointestinal bleeding in early infancy. J Pediatr Gastroenterol Nutr 2007; 44:501-5. https://doi.org/10.1097/01.mpg.0000252194.06955.18
  7. Machida HM, Catto Smith AG, Gall DG, Trevenen C, Scott RB. Allergic colitis in infancy: clinical and pathologic aspects. J Pediatr Gastroenterol Nutr 1994;19:22-6. https://doi.org/10.1097/00005176-199407000-00004
  8. Hwang JB, Park MH, Kang YN, Kim SP, Suh SI, Kam S. Advanced criteria for clinicopathological diagnosis of food protein-induced proctocolitis. J Korean Med Sci 2007;22:213-7. https://doi.org/10.3346/jkms.2007.22.2.213
  9. Norwak-Wegrzyn A. Food protein-induced enterocolitis, enteropathy, and proctocolitis. In: Metcalfe DD, Sampson HA, Simon RA, editors. Food allergy: adverse reactions to foods and food additives. 3rd ed. Baltimore: Blackwell Publishing Inc., 2003;227-41.
  10. Forsyth BW, McCarthy PL, Leventhal JM. Problems of early infancy, formula changes, and mothers' beliefs about their infants. J Pediatr 1985;106:1012-7. https://doi.org/10.1016/S0022-3476(85)80260-2
  11. Bock SA. The natural history of food sensitivity. J Allergy Clin Immunol 1982;69:173-7. https://doi.org/10.1016/0091-6749(82)90096-3
  12. Lake AM, Whitington PF, Hamilton SR. Dietary protein-induced colitis in breast-fed infants. J Pediatr 1982;101:906-10. https://doi.org/10.1016/S0022-3476(82)80008-5
  13. Laitinen K, Arvola T, Moilanen E, Lampi AM, Ruuska T, Isolauri E. Characterization of breast milk received by infants with gross blood in stools. Biol Neonate 2005;87:66-72. https://doi.org/10.1159/000081955
  14. Anveden-Hertzberg L, Finkel Y, Sandstedt B, Karpe B. Proctocolitis in exclusively breast-fed infants. Eur J Pediatr 1996;155:464-7. https://doi.org/10.1007/BF01955182
  15. Pumberger W, Pomberger G, Geissler W. Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood. Postgrad Med J 2001;77:252-4. https://doi.org/10.1136/pmj.77.906.252
  16. Kokkonen J, Karttunen TJ, Niinimäki A. Lymphonodular hyperplasia as a sign of food allergy in children. J Pediatr Gastroenterol Nutr 1999;29:57-62. https://doi.org/10.1097/00005176-199907000-00015
  17. Kokkonen J, Karttunen TJ. Lymphonodular hyperplasia on the mucosa of the lower gastrointestinal tract in children: an indication of enhanced immune response? J Pediatr Gastroenterol Nutr 2002;34:42-6. https://doi.org/10.1097/00005176-200201000-00010
  18. Patel L, Garvey B, Arnon S, Roberts IA. Eosinophilia in newborn infants. Acta Paediatr 1994;83:797-801. https://doi.org/10.1111/j.1651-2227.1994.tb13146.x
  19. Yen JM, Lin CH, Yang MM, Hou ST, Lin AH, Lin YJ. Eosinophilia in very low birth weight infants. Pediatr Neonatol 2010;51:116-23. https://doi.org/10.1016/S1875-9572(10)60021-6
  20. Jang HJ, Kim AS, Hwang JB. The etiology of small and fresh rectal bleeding in not-sick neonates: should we initially suspect food protein-induced proctocolitis? Eur J Pediatr 2012;171:1845-9. https://doi.org/10.1007/s00431-012-1825-2
  21. Choi SY, Park MH, Choi WJ, Kang U, Oh HK, Kam S, et al. Clinical features and the natural history of dietary protein induced proctocolitis: a study on the elimination of offending foods from the maternal diet. Korean J Pediatr Gastroenterol Nutr 2005;8:21-30.
  22. Arvola T, Ruuska T, Keranen J, Hyoty H, Salminen S, Isolauri E. Rectal bleeding in infancy: clinical, allergological, and microbiological examination. Pediatrics 2006;117:e760-8. https://doi.org/10.1542/peds.2005-1069

피인용 문헌

  1. Non-IgE-mediated gastrointestinal food allergies vol.29, pp.6, 2017, https://doi.org/10.1097/mop.0000000000000554
  2. Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report vol.11, pp.None, 2017, https://doi.org/10.1186/s13256-017-1318-z
  3. Food Protein-Induced Proctocolitis vol.64, pp.1, 2013, https://doi.org/10.21508/1027-4065-2019-64-1-120-124
  4. Feeding-based treatment of allergic proctocolitis and associated clinical outcomes vol.40, pp.None, 2013, https://doi.org/10.1016/j.clnesp.2020.09.013
  5. Rectal bleeding and cow’s milk protein‐induced allergic proctocolitis: A prospective study vol.51, pp.9, 2013, https://doi.org/10.1111/cea.13896
  6. Non-IgE-Mediated Gastrointestinal Food Protein-Induced Allergic Disorders. Clinical Perspectives and Analytical Approaches vol.10, pp.11, 2021, https://doi.org/10.3390/foods10112662