Abstract
Cow's milk proteins induce noxious effects on the mucosae of the upper gastrointestinal tract. The purpose of this study is to appreciate the incidence of colonic involvement in cow's milk protein intolerance (CMPI) with confirmed villous atrophy.
29 children were investigated (17 boys-12 girls), aged 1 to 10 months. All received cow's milk protein for at least 20 consecutives days. Clinical symptoms and specifications of the diarrhea were collected. Jejunal biopsies were obtained with Watson's probe beyond Treitz flexure; all cases presented villous atrophy : partial:n=9, subtotal:n=13 and total:n=7. Colonoscopies and biopsies were performed with fiberscopes allowing rectosigmoid examination in all cases, exploration of the left colon in 12 cases and right colon in 3 cases. The degree of inflammation was quoted:normal moderate or severe according to endoscopic and pathologic data.
Results: only nine children presented mucus and blood in their stools evoking colitis. Correlation between endoscopic and clinical features were as follow:-both examinations were normal in 2 patients -19 apparently normal endoscopies displayed indisputable pathological signs of inflammation -8 patients showed both abnormal examinations and most particularly 2 children with severe ulcerative and hemorragic colitis.
Colonic mucosal inflammation was found in 93% of our cases. These microscopic lesions were moderate in 86%, but in 7% severe acute colitis was observed. These data seem to give evidence of the lesions throughout all the gastro intestinal tract during CMPI.
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Olives, J., Le Tallec, C., Bloom, E. et al. 43 COLITIS AND COW'S MILK PROTEIN SENSITIVE ENTEROPATHY. Pediatr Res 24, 412 (1988). https://doi.org/10.1203/00006450-198809000-00066
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DOI: https://doi.org/10.1203/00006450-198809000-00066