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《The Journal of Clinical Pediatrics》 2006-10
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The diagnosis and management of allergic colitis in children

LI Zhong- yue, MA Min, CHEN Jie. Department of Gastroenterology, Children's Hospital Affiliated to Medical School, Zhejiang University, Zhejiang Hangzhou 310003, China  
Objectives To analyse the clinical manifestation,endoscopic and histopathological features,clinical history,laboratory findings and management of allergic colitis (AC) in children and explore the key issues of diagnosis and treatment for AC in children. Methods The clinical manifestation, endoscopic and histopathological features,laboratory findings and management of 33 children (ranged from 35 days to 14 years) with AC were studied. Results ① AC was commonly found in children under 2 years old,24 cases (72.7 %). The common clinical manifestations included diarrhea 28 cases (84.8 %) and hemafecia 25 cases (75.8 %),abdominal pain 12 cases (36.4 %),loss of body weight 7 cases (21.2 %),hypoproteinemia 5 cases (15.2 %),abdominal distension 3 cases (9 %),vomiting 3 cases (9 %),pleural effusion 1 case (3 %) and ascites 1 case (3 %). ② By using endoscopy,focal erythema and friable appearing mucosa were observed in 7 cases (21.2 %),increased nodularity in 12 cases (36.4 %),decreased mucosa vascularity and multiple superficial erosions in 10 cases (30.3 %) and frank ulcerations with surface exudates in 4 cases (12.1 %). Rectum (24 cases, 72.7 %) and sigmoid colon (28 cases,84.8 %) were the most frequently involved. Histopathological changes included mild to moderate focal infiltrates of esoinophils in all mucosal compartments,particularly in the lamina propria (94 %). ③ Laboratory findings showed hypo- hemoglobinemia (23 cases),peripheral eosinophilia (8 cases),low serum albumin (5 cases), low serum Ig A (6 cases) and high serum Ig E (6 cases). In Vitro Test (IVT) of allergens was performed in 18 cases and 9 cases showed positive results. The allergens included cow's milk (3 cases),seafood (crab,fish and shrimp,3 cases) and hen egg (2 cases) and ragweed (1 case). Eleven children had history of allergy. Correlation between the onset of AC and food intake was indicated in 10 children (cow's milk 6 cases,hen egg 2 cases,soy product 1 case and animal liver 1 case). Five cases had maternal history of intake of cow's milk and seafood. ④ All the children were hospitalized and dismissed after symptomatic relief (average 10.2 ± 4.7 days). Conclusions Children with AC varied with clinical manifestations and endoscopic features. It is important to acquire a detailed history,laboratory and endoscopic findings,and multiple mucosal biopsy specimens for diagnosis. Stopping the intake of suspected allergic food is the key to the management.
【CateGory Index】: R725.7
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