Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Pediatr Gastroenterol Nutr. 2012 Dec;55(6):711-6. doi: 10.1097/MPG.0b013e318268da40.
Cow's-milk protein is one of the food antigens responsible for causing eosinophilic esophageal inflammation in a majority of children. We describe our experience with treating eosinophilic esophagitis (EoE) in children by eliminating only cow's milk from their diets.
This retrospective study assessed the short-term clinical and histological response to eliminating cow's-milk protein from the diet of children with EoE. Only patients undergoing a subsequent upper endoscopy to assess their histological response were included in this analysis.
We identified 17 (12 boys and 5 girls) children with EoE who excluded only cow's milk from their diet. Remission was induced in 11 of 17 (65%) patients; within the remission group, 7 (41%) achieved complete histological remission and 4 patients (24%) were in significant histological remission. The mean peak pre- and posttreatment counts for those in remission were 76 ± 40 and 2 ± 4 (P < 0.01), respectively.
Elimination of cow's milk-induced clinical and histological remission in 65% (95% confidence interval 42%-88%) of children with EoE in whom it was attempted. This approach offers distinct advantages over other dietary treatment approaches for the initial management of children with EoE. The role of eliminating cow's milk alone for the treatment of EoE warrants further prospective study.
牛奶蛋白是引起大多数儿童嗜酸性食管炎的食物抗原之一。我们描述了通过从饮食中仅去除牛奶来治疗儿童嗜酸性食管炎（EoE）的经验。
本回顾性研究评估了通过饮食排除牛奶蛋白对 EoE 患儿的短期临床和组织学反应。仅对接受后续上内窥镜检查以评估其组织学反应的患者进行了此项分析。
我们确定了 17 名（12 名男孩和 5 名女孩）仅从饮食中排除牛奶的 EoE 患儿。在 17 名患者中，有 11 名（65％）诱导缓解；在缓解组中，7 名（41％）达到完全组织学缓解，4 名（24％）为显著组织学缓解。缓解组的平均峰值治疗前和治疗后计数分别为 76±40 和 2±4（P<0.01）。
尝试通过饮食排除牛奶可使 65％（95％置信区间为 42％-88％）的 EoE 患儿获得临床和组织学缓解。与其他饮食治疗方法相比，这种方法为 EoE 患儿的初始治疗提供了明显的优势。单独通过饮食排除牛奶来治疗 EoE 的作用需要进一步的前瞻性研究。
