Feiterna-Sperling C, Rammes S, Kewitz G, Versmold H, Niggemann B
Children's Hospital, Charité-Virchow-Klinikum, Humboldt University, Berlin, Germany.
Pediatr Allergy Immunol. 1997 Aug;8(3):153-5. doi: 10.1111/j.1399-3038.1997.tb00170.x.
Clinical manifestations of cow's milk allergy rarely occur in the first days after birth. We report on a newborn presenting with hemorrhagic meconium in the first hour of life followed by bloody diarrhea in the next few days. At day 14, an elevated total IgE, specific IgE to cow's milk and an eosinophilia in peripheral blood were found. Symptoms disappeared when the milk feed was changed to an extensively hydrolyzed casein-formula. Two challenges with cow's milk formula (on day 30 and at 7 months of age) were followed by recurrence of vomiting, watery diarrhea and failure to thrive. At the age of 17 months cow's milk was tolerated well. Although other pathogenetic mechanisms cannot completely be ruled out, there is strong evidence that cow's milk allergy--induced by intra-uterine sensitization--explains the symptoms in our patient. In conclusion, cow's milk allergy can occur even in the first days of life, and our clinical observation supports the concept of intra-uterine sensitization to allergens.
牛奶过敏的临床表现很少在出生后的头几天出现。我们报告一例新生儿，出生后第一小时排出血性胎便，随后在接下来的几天出现血性腹泻。在第14天时，发现总IgE升高、对牛奶的特异性IgE以及外周血嗜酸性粒细胞增多。当将奶喂养改为深度水解酪蛋白配方奶时，症状消失。两次使用牛奶配方奶激发试验（分别在第30天和7个月大时）后，出现呕吐、水样腹泻复发以及生长发育迟缓。在17个月大时，患儿能够很好地耐受牛奶。尽管不能完全排除其他发病机制，但有强有力的证据表明，我们的患者症状是由宫内致敏引起的牛奶过敏所致。总之，牛奶过敏甚至可在出生后的头几天发生，我们的临床观察支持宫内致敏于过敏原的概念。
