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过敏性直肠结肠炎:一种具有家族倾向的短暂性疾病的临床演变。病例报告。

Allergic proctocolitis: the clinical evolution of a transitory disease with a familial trend. Case reports.

作者信息

Fagundes-Neto Ulysses, Ganc Arnaldo José

出版信息

Einstein (Sao Paulo). 2013 Apr-Jun;11(2):229-33. doi: 10.1590/s1679-45082013000200017.

Abstract

Allergic colitis is a clinical manifestation of food allergy during the first months of life. It is estimated that genetic factors play a role in the expression of this allergic disease. This case report described the clinical progress of infants who were cousins from two distinct family groups with allergic colitis. Five infants under six months of age and of both sexes were studied, with a diagnosis of allergic colitis characterized clinically and histologically by (1) rectal bleeding; (2) exclusion of infectious causes of colitis; (3) disappearance of symptoms after elimination of cow's milk and dairy products from the child's and/or the mother's diet. Patients were submitted to the following diagnostic investigation: complete blood count; stool culture; parasitologic examination of stools; rectoscopy or colonoscopy; and rectal biopsy. Patient age varied from 40 days to six months; three were males. All patients presented with complaints of intense colic and rectal bleeding. The colonoscopy showed presence of hyperemia of the mucosa with microerosions and spontaneous bleeding upon the procedure. Microscopy revealed the existence of colitis with eosinophilia > 20 e/HPF. Patients were treated with a hypoallergenic formula and showed remission of symptoms. After one year of age, all were submitted to an oral challenge with a milk formula and presented food tolerance. Allergic colitis is a disease with evident genetic inheritance and a temporary character.

摘要

过敏性结肠炎是生命最初几个月食物过敏的一种临床表现。据估计,遗传因素在这种过敏性疾病的表现中起作用。本病例报告描述了来自两个不同家族群体的患过敏性结肠炎的表亲婴儿的临床病程。研究了5名6个月以下的男女婴儿,诊断为过敏性结肠炎,其临床和组织学特征为:(1)直肠出血;(2)排除结肠炎的感染性病因;(3)从儿童和/或母亲的饮食中去除牛奶和乳制品后症状消失。患者接受了以下诊断检查:全血细胞计数;粪便培养;粪便寄生虫学检查;直肠镜或结肠镜检查;以及直肠活检。患者年龄从40天到6个月不等;3名是男性。所有患者均有剧烈腹痛和直肠出血的主诉。结肠镜检查显示黏膜充血,有微糜烂,操作时出现自发性出血。显微镜检查显示存在嗜酸性粒细胞增多>20个/HPF的结肠炎。患者接受低敏配方奶粉治疗,症状缓解。1岁以后,所有患者都接受了牛奶配方奶粉的口服激发试验,并表现出食物耐受性。过敏性结肠炎是一种具有明显遗传倾向且具有暂时性的疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac66/4872900/5ae91814152a/1679-4508-eins-11-02-0229-gf01.jpg

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