Iacono Giuseppe, Di Prima Lidia, D'Amico Domenico, Scalici Calogero, Geraci Girolamo, Carroccio Antonio
Department of Pediatric Gastroenterology, Di Cristina Hospital, Palermo, Italy.
J Pediatr Gastroenterol Nutr. 2006 May;42(5):531-4. doi: 10.1097/01.mpg.0000221898.53534.f5.
Red umbilicus is considered to be an infectious disease typical of neonates. In our experience, umbilical erythema could be due to cow's milk protein intolerance (CMPI).
To evaluate the frequency and clinical significance of umbilical erythema in a series of consecutive children referred for suspected CMPI.
Seven hundred ninety-six consecutive patients (median age, 18 months) referred for suspected CMPI diagnosis were studied. CMPI diagnosis was based on the disappearance of symptoms on elimination diet and their subsequent reappearance on double-blind placebo-controlled cow's milk challenge.
CMPI was diagnosed in 384 patients: 120 with respiratory, 75 dermatologic and 198 gastroenterological symptoms. Although some patients showed more than 1 type of symptom, whether gastroenterological, dermatologic or respiratory, they were classified in 1 category only according to the main reason for referral to the outpatients clinic. Umbilical erythema was observed in 36 patients (median age, 10 months): 16 (8%) with gastroenterological symptoms, 9 (7.5%) with recurrent asthma and 11 (15%) with atopic dermatitis. None of the symptomatic controls without CMPI had umbilical erythema. On elimination diet, the erythema disappeared within the second week. On CMPI challenge, it reappeared within 24 hours.
Umbilical erythema can be a sign of food intolerance and can be a useful diagnostic tool for CMPI.
脐部发红被认为是新生儿特有的一种感染性疾病。根据我们的经验，脐部红斑可能是由于牛奶蛋白不耐受（CMPI）引起的。
评估一系列因疑似CMPI前来就诊的连续儿童中脐部红斑的发生率及临床意义。
对796例因疑似CMPI诊断前来就诊的连续患者（中位年龄18个月）进行了研究。CMPI的诊断基于在排除饮食时症状消失，以及随后在双盲安慰剂对照的牛奶激发试验中症状再次出现。
384例患者被诊断为CMPI：120例有呼吸道症状，75例有皮肤症状，198例有胃肠道症状。尽管有些患者表现出不止一种症状类型，无论是胃肠道、皮肤还是呼吸道症状，但仅根据转诊至门诊的主要原因将他们归为一类。36例患者（中位年龄10个月）出现脐部红斑：16例（8%）有胃肠道症状，9例（7.5%）有复发性哮喘，11例（15%）有特应性皮炎。无CMPI的有症状对照者均无脐部红斑。在排除饮食时，红斑在第二周内消失。在CMPI激发试验时，红斑在24小时内再次出现。
脐部红斑可能是食物不耐受的一个迹象，并且可能是CMPI的一种有用的诊断工具。
