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. 1979 Jan;54(1):39–43. doi: 10.1136/adc.54.1.39

Cows' milk protein-sensitive enteropathy: an important contributing cause of secondary sugar intolerance in young infants with acute infective enteritis.

N Iyngkaran, K Davis, M J Robinson, C G Boey, E Sumithran, M Yadav, S K Lam, S D Puthucheary
PMCID: PMC1545196  PMID: 570376

Abstract

The effect of cows' milk protein (CMP) on the mucosal disaccharidases was investigated in 23 infants with acute infective enteritis. Jejunal biopsies performed before and after cows' milk provocation were subjected to histological examination and to mucosal disaccharidase enzyme (lactase, sucrase, and maltase) analyses. After milk challenge, changes in mucosal histology were observed in 18 infants, in 17 of them the levels of all 3 mucosal disaccharidases were much reduced. 10 of these infants developed diarrhoea and, in 6, the stools were positive for reducing sugar. It is concluded that CMP has a deleterious effect on the jejunal mucosa of young infants recovering from infective enteritis, so that in the management of young infants with sugar intolerance secondary to infective enteritis, CMP and lactose should be excluded from the diet.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnes G. L., Townley R. R. Duodenal mucosal damage in 31 infants with gastroenteritis. Arch Dis Child. 1973 May;48(5):343–349. doi: 10.1136/adc.48.5.343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Chandrasekaran R., Kumar V., Walia B. N., Moorthy B. Carbohydrate intolerance in infants with acute diarrhoea and its complications. Acta Paediatr Scand. 1975 May;64(3):483–488. doi: 10.1111/j.1651-2227.1975.tb03869.x. [DOI] [PubMed] [Google Scholar]
  3. Harrison M., Kilby A., Walker-Smith J. A., France N. E., Wood C. B. Cows' milk protein intolerance: a possible association with gastroenteritis, lactose intolerance, and IgA deficiency. Br Med J. 1976 Jun 19;1(6024):1501–1504. doi: 10.1136/bmj.1.6024.1501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Iyngkaran N., Robinson M. J., Prathap K., Sumithran E., Yadav M. Cows' milk protein-sensitive enteropathy. Combined clinical and histological criteria for diagnosis. Arch Dis Child. 1978 Jan;53(1):20–26. doi: 10.1136/adc.53.1.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Iyngkaran N., Robinson M. J., Sumithran E., Lam S. K., Puthucheary S. D., Yadav M. Cows' milk protein-sensitive enteropathy. An important factor in prolonging diarrhoea of acute infective enteritis in early infancy. Arch Dis Child. 1978 Feb;53(2):150–153. doi: 10.1136/adc.53.2.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. KERRY K. R., ANDERSON C. M. A WARD TEST FOR SUGAR IN FAECES. Lancet. 1964 May 2;1(7340):981–981. doi: 10.1016/s0140-6736(64)91777-5. [DOI] [PubMed] [Google Scholar]
  7. Kamath K. R., Murugasu R. A comparative study of four methods for detecting Giardia lamblia in children with diarrheal disease and malabsorption. Gastroenterology. 1974 Jan;66(1):16–21. [PubMed] [Google Scholar]
  8. Lifshitz F., Coello-Ramirez P., Gutierrez-Topete G., Cornado-Cornet M. C. Carbohydrate intolerance in infants with diarrhea. J Pediatr. 1971 Nov;79(5):760–767. doi: 10.1016/s0022-3476(71)80388-8. [DOI] [PubMed] [Google Scholar]
  9. Lifshitz F., Coello-Ramírez P., Gutiérrez-Topete G. Monosaccharide intolerance and hypoglycemia in infants with diarrhea. I. Clinical course of 23 infants. J Pediatr. 1970 Oct;77(4):595–603. doi: 10.1016/s0022-3476(70)80200-1. [DOI] [PubMed] [Google Scholar]
  10. MACDONALD W. C., DOBBINS W. O., 3rd, RUBIN C. E. STUDIES OF THE FAMILIAL NATURE OF CELIAC SPRUE USING BIOPSY OF THE SMALL INTESTINE. N Engl J Med. 1965 Mar 4;272:448–456. doi: 10.1056/NEJM196503042720903. [DOI] [PubMed] [Google Scholar]
  11. Taylor B., Norman A. P., Orgel H. A., Stokes C. R., Turner M. W., Soothill J. F. Transient IgA deficiency and pathogenesis of infantile atopy. Lancet. 1973 Jul 21;2(7821):111–113. doi: 10.1016/s0140-6736(73)93060-2. [DOI] [PubMed] [Google Scholar]
  12. Walker-Smith J., Paterson H., Keating S. Evaluation of a new feeding formula for sugar malabsorption. Med J Aust. 1973 Jul 21;2(3):107–110. [PubMed] [Google Scholar]
  13. Walker W. A. Antigen absorption from the small intestine and gastrointestinal disease. Pediatr Clin North Am. 1975 Nov;22(4):731–746. doi: 10.1016/s0031-3955(16)33204-7. [DOI] [PubMed] [Google Scholar]

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