Burge David, Drewett Melanie, Hall Nigel
University Hospital Southampton and University of Southampton, Southampton, UK,
Pediatr Surg Int. 2015 Mar;31(3):271-6. doi: 10.1007/s00383-015-3664-5. Epub 2015 Jan 28.
BACKGROUND/PURPOSE: To determine the frequency and characteristics of suspected cow's milk protein allergy (CMPA) in infants with gastroschisis and response to change in milk.
A retrospective cohort study of 111 consecutive infants with gastroschisis.
64 episodes suggesting non-IgE-mediated CMPA occurred in 50 infants (45 %) at a median age of 44 days (9-186) and during the primary admission in 38 %. At the time of the episode the infant feed was breast milk (BM, n = 24), term formula (TF, n = 20) or extensively hydrolysed formula (EHF, n = 6). The feed was changed to EHF (34), amino acid formula (AAF) (14) or BM with maternal CMP-free diet (2). Partial or complete resolution of symptoms occurred in all. There was histological evidence of an allergic reaction to CMP in all four infants in whom tissue was available. Recurrent episodes occurred in 13/50 infants (26 %), 10 of whom were receiving EHF. There were no recurrent episodes in infants being fed with AAF.
Features suggesting non-IgE-mediated CMPA appear common in infants with gastroschisis.
背景/目的：确定腹裂婴儿疑似牛奶蛋白过敏（CMPA）的发生率和特征，以及对牛奶变化的反应。
对111例连续的腹裂婴儿进行回顾性队列研究。
50例婴儿（45%）出现64次提示非IgE介导的CMPA发作，中位年龄为44天（9 - 186天），38%发生在首次住院期间。发作时婴儿的喂养方式为母乳（BM，n = 24）、足月配方奶（TF，n = 20）或深度水解配方奶（EHF，n = 6）。喂养方式改为EHF（34例）、氨基酸配方奶（AAF）（14例）或母亲食用无CMP饮食的母乳（2例）。所有症状均部分或完全缓解。在有组织样本的4例婴儿中，均有对CMP过敏反应的组织学证据。13/50例婴儿（26%）出现复发，其中10例正在接受EHF喂养。接受AAF喂养的婴儿无复发。
提示非IgE介导的CMPA的特征在腹裂婴儿中似乎很常见。
