Sorea S, Dabadie A, Bridoux-Henno L, Balançon-Morival M, Jouan H, Le Gall E
Département de médecine de l'enfant et de l'adolescent, hôpital Sud, 16, boulevard de Bulgarie, 35056 Rennes cedex, France.
Arch Pediatr. 2003 Sep;10(9):772-5. doi: 10.1016/s0929-693x(03)00299-9.
Authors report clinical, biological and endoscopic data of six children aged less 3 months with bloody stools while they were exclusively breast-fed.
Two girls and four boys aged 1 to 2 months presented with isolated but recurrent rectal bleeding. All were explored by fiberoptic rectosigmoidoscopy between 1 and 3,2 months. Macroscopic aspects were congestion (6 cases), petechial and ecchymotic (4 cases), with normal mucosal areas (5 cases). Histopathology showed eosinophilic infiltrates in all 5 children with rectal biopsy. Evolution was satisfactory after cow's milk protein exclusion in maternal diet for five children and after weaning in 1. All children were weaned with protein hydrolysate. Cow's milk protein were later introduced without adverse reactions at 6 to 23 months.
Food allergy can be considered in proctocolitis including exclusive breast-fed children. Evolution after maternal diet is, as usual, simple.
作者报告了6名3个月以下纯母乳喂养时出现便血的儿童的临床、生物学和内镜检查数据。
2名女孩和4名男孩，年龄在1至2个月，表现为孤立但反复的直肠出血。所有患儿在1至3.2个月期间接受了纤维乙状结肠镜检查。宏观表现为充血（6例）、瘀点和瘀斑（4例），黏膜区域正常（5例）。组织病理学显示，5例接受直肠活检的儿童均有嗜酸性粒细胞浸润。5名儿童在母亲饮食中排除牛奶蛋白后病情好转，1名儿童断奶后病情好转。所有儿童均采用蛋白水解物断奶。牛奶蛋白随后在6至23个月时引入，未出现不良反应。
在包括纯母乳喂养儿童在内的直肠结肠炎中，可考虑食物过敏。母亲饮食调整后的病情发展通常较为简单。
