Aktaş Selma, Ergenekon Ebru, Ünal Sezin, Türkyılmaz Canan, Hirfanoğlu İbrahim Murat, Atalay Yıldız
Division of Neonatology, Department of Pediatrics, Gaziosmanpasa Taksim Research and Training Hospital, İstanbul, Turkey.
Division of Neonatology, Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2017;59(3):322-328. doi: 10.24953/turkjped.2017.03.015.
Aktaş S, Ergenekon E, Ünal S, Türkyılmaz C, Hirfanoğlu İM, Atalay Y. Different presentations of Cow's milk protein allergy during neonatal period. Turk J Pediatr 2017; 59: 322-328. Cows milk protein allergy (CMPA) is the most common cause of allergy occurring in the first year of life due to infant formula or breast-milk of mothers who are drinking cows milk or eating cow's milk products. Most children with allergic colitis are symptomatic in the first months, usually by 4 weeks. There are rare cases whom were sensitized prenatally and demonstrated symptoms in the first week, even in the first 2 days of life. The most common clinical sign of CMPA is bloody stool in a well-appearing infant. Gross bloody stool or fecal occult blood are also the common signs of necrotizing enterocolitis (NEC), especially in preterm infants with systemic instability. The treatment options are totally different so the clinician has to be very careful evaluating the patient. We report 5 preterm cases of CMPA, two of whom were siblings. Two of them presented with massive bloody stools and 3 of them presented with abdominal distension and fecal occult blood all of which were initially considered as NEC. Literature review of 20 cases with similar history is summarized as well.
阿克塔什 S、埃尔盖内孔 E、于纳尔 S、蒂尔基尔马兹 C、希尔法诺卢 IM、阿塔莱 Y。新生儿期牛奶蛋白过敏的不同表现。《土耳其儿科学杂志》2017 年；59: 322 - 328。牛奶蛋白过敏（CMPA）是婴儿出生后第一年因食用婴儿配方奶粉或母亲饮用牛奶或食用奶制品的母乳而发生过敏的最常见原因。大多数过敏性结肠炎患儿在最初几个月出现症状，通常在 4 周时。有罕见病例在产前致敏并在出生后第一周甚至出生后前两天就出现症状。CMPA 最常见的临床体征是看似健康的婴儿出现血便。肉眼可见的血便或粪便潜血也是坏死性小肠结肠炎（NEC）的常见体征，尤其是在全身状况不稳定的早产儿中。治疗方案完全不同，因此临床医生在评估患者时必须非常谨慎。我们报告了 5 例早产儿 CMPA 病例，其中 2 例是兄弟姐妹。其中 2 例出现大量血便，3 例出现腹胀和粪便潜血，所有这些最初都被认为是 NEC。还总结了对 20 例有类似病史病例的文献综述。
