Shiner M, Ballard J, Brook C G, Herman S
Lancet. 1975 Nov 29;2(7944):1060-3. doi: 10.1016/s0140-6736(75)90431-6.
4 infants, suspected of cow's milk protein intolerance, were placed on an elimination diet and then challenged with cow's milk. None reacted clinically, yet in 2 of the 4 patients jejunal biopsy revealed clear histological, ultrastructural, and immunological changes. It is suggested that these changes are the objective criteria on which the diagnosis of cow's milk intolerance should be based, and that the clinical evidence derived from milk challenge after an elimination diet may be unreliable.
4名疑似牛奶蛋白不耐受的婴儿接受了排除饮食，然后用牛奶进行激发试验。临床上均无反应，但4名患者中有2名空肠活检显示出明显的组织学、超微结构和免疫学变化。提示这些变化是诊断牛奶不耐受应依据的客观标准，并且排除饮食后牛奶激发试验得出的临床证据可能不可靠。
