Table 1.
Major features of the 14 exclusively breast-fed infants with allergic proctocolitis
| Patient (sex) |
Clinical Onset | Maternal elimination. diet (*) | Our observation | Atopy patch test | Endoscopic features | Histology Eosinophiles 10HPF (40x) | Current status (age) | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age (days) | Symptoms | Allergen avoidance | Duration | Age (days) | Symptoms | Baseline | Follow-up (**) | Baseline | Follow-up (**) | |||
| 1 (F) | 60 | Haematochezia; GERD | CM S |
4 weeks | 90 | Severe rectal bleeding; syderopenic anemia | BM ++++ CM + |
Scattered erosions; ileo-colonic LNH | Normal mucosa | > 60 | Normal features | Free diet, well (by 3 years) |
| 2 (M) | 90 | Haematochezia; GERD | CM E S |
8 weeks | 180 | Melena; hematemesis | BM +++ CM ++ |
Diffuse erosions; ileal LNH | Mild LNH | > 60 | Normal features | Free diet, well (by 2 years) |
| 3 (M) | 120 | Chronic diarrhea | CM E |
6 weeks | 160 | Severe rectal bleeding | BM ++ S + |
Scattered erosions; ileo-colonic LNH | Mild LNH | > 60 | Normal features | Free diet, well (by 2 years) |
| 4 (M) | 10 | Blood and mucus in stools | CM E S |
3 weeks | 30 | Hematochezia | BM +++ CM + E + |
Friability; initial LNH | Normal mucosa | 40-50 | Normal features | CM and E-free diet (13 months) |
| 5 (M) | 20 | Bloody diarrhea | CM | 1 week | 30 | Bloody diarrhea; syderopenic anemia | BM ++ | Scattered erosions; initial LNH | Normal mucosa | 40-50 | Normal features | Free diet, well (by 15 months) |
| 6 (F) | 20 | Hematochezia; GERD | CM S |
9 weeks | 120 | Diarrhea; mucus in stools | BM +++ | Diffuse LNH | Mild LNH | > 60 | Normal features | CM and E-free diet (11 months) |
| 7 (M) | 7 | Fluid diarrhoea and feeding refusal | CM E |
1 week | 15 | Hematochezia | CM ++ R + |
Rectal erosions | Normal mucosa | 40-50 | Normal features | CM and R-free diet (7 months) |
| 8 (M) | 180 | Haematochezia | CM E S |
2 weeks | 195 | Severe rectal bleeding; dehydration | BM + CM ++ E ++ S ++ W + R ++ | Diffuse LNH | Normal mucosa | > 60 | Normal features | CM, S, E and R-free diet (15 months) |
| 9 (F) | 40 | Blood and mucus in stools | CM E |
3 weeks | 60 | Hematochezia | BM ++++ | Hedema; hyperhemia; scattered erosions | Normal mucosa | 40-50 | Normal features | CM and E-free diet (16 months) |
| 10 (M) | 28 | Blood and mucus in stools; colics | CM E S |
4 weeks | 60 | Bloody diarrhea; mucus in stools | BM ++ S ++ |
Diffuse erosions; ileo-colonic LNH | Normal mucosa | > 60 | Normal features | Free diet, well (by 1 year) |
| 11 (M) | 30 | Blood and mucus in stools; colics | CM S |
4 weeks | 60 | Severe rectal bleeding; colics | BM +++ CM + |
Scattered erosions; friability; ileo-colonic LNH | Normal mucosa | 40-50 | Normal features | Free diet, well (by 1 year) |
| 12 (F) | 45 | Diarrhea with mucus and blood; irritability | CM E S |
6 weeks | 60 | Severe rectal bleeding | BM +++ CM + S + | Scattered erosions; ileo-colonic LNH | Mild LNH | 40-50 | Normal features | Free diet, well (by 1 year) |
| 13 (M) | 20 | Blood and mucus in stools; colics | CM | 1 week | 30 | Bloody diarrhea; mucus in stools | BM + E + |
Scattered erosions; friability ileo-colonic LNH | Normal mucosa | > 60 | Normal features | CM and E-free diet (14 months) |
| 14 (M) | 21 | Diarrhea with mucus and blood; irritability | CM E S |
1 week | 30 | Bloody diarrhea; irritability | BM++ | Diffuse erosions; ileal LNH | Normal mucosa | > 60 | Normal features | Free diet, well (by 1 year) |
(*) the diet was empirically administered by pediatricians before our observation; (**) after 30 days of exclusively elimination diet with amino acid-based formula; GERD = gastroesophageal reflux disease; HPF = high power field; LNH = lymphoid nodular hyperplasia; CM = cow's milk; E = egg; S = soy; W = wheat; R = rice; BM = breast milk.