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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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【Co-references】
Chinese Journal Full-text Database 5 Hits
1 LI Jun, XU Ling-Fen, SUN Mei, LI Qiang, GAO Hong, JIANG Wei-Guo. Department of Pediatrics, Second Affiliated Hospital of China Medical University, Shenyang 110004, China;Protective effects of recombinant intestinal trefoil factor against intestinal injuries induced by endotoxin in young rats[J];Chinese Journal of Contemporary Pediatrics;2006-05
2 ZHANG Yucai, ZHANG Yuming,XU Liang,TANG Dinghua. Intensive Care Unit ,Children's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200040,China;Septic shock and multiple organ dysfunction syndrome from gastroenteritis in children[J];Chinese Journal of Emergency Medicine;2006-06
3 HUA Ying,LIU Wei,CHEN Shun- nian,XU Chun- di . Department of Pediatrics,Ruijin Hospital Affiliated to Medical College,Shanghai Jiaotong University,Shanghai 200025,China;Clinical observation of esomeprazole therapy for gastro- oesophageal reflux disease in children[J];The Journal of Clinical Pediatrics;2006-08
4 CHEN Xiao-you,JIANG Mi-zu,WANG Cai-fu,YU Jin-dan. The Children's Hospital of Zhejiang University School of Medicine,Zhejiang Hangzhou 310003,China;Gastroesophageal reflux in infants with lower respiratory tract infection[J];The Journal of Clinical Pediatrics;2006-09
5 WANG Xian-liang, ZHANG Er-hua, HOU Guang-jun, et al Department of Surgery, Zhengzhou City Children Hospital, Zhengzhou, 450053, China.;Differential Diagnosis And Assistant Treatment of Obstructive Jaundice Using Laparoscope[J];Journal of Clinical Pediatric Surgery;2006-04
【Secondary References】
Chinese Journal Full-text Database 1 Hits
1 CHEN Bo,XIE Yong-wu,ZHENG Rui-feng(Zhuhai Maternal and Child Health Caring Hospital,Guangdong Zhuhai 519000,China);166 Cases of Gastroscopy and Analysis of Chronic Gastritis,Chronic Duodenitis and Peptic Ulcer in Children[J];Hebei Medicine;2008-02
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