Bloody Stool in Infants: A Pediatric Allergy View

G. Atakul, S. Şirin, Özge Atay, Özge Kangallı Boyacıoğlu, S. Al, S. Asilsoy, N. Uzuner, Ö. Karaman
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Abstract

Objective: The prevalence of food allergy (FA) has gradually increased. Bloody stool is among the symptoms associated with non-immunoglobulin E (IgE) mediated FA in infants. In our study, we shared the clinical characteristics of the patients who applied to our clinic with bloody stool. Material and Methods: The data of the patients with bloody stool were reviewed. Patients’ characteristics and the time of onset of tolerance in patients with FA were recorded, retrospectively. Results: The 110 patient files were reviewed. 68% of the patients were diagnosed with FA (63 proctocolitis/12 enterocolitis), 22% with an anal fissure, and 9% with nonspecific colitis. The most common causative food was cow milk (57%), the second was the combination of egg and milk (24.2%), and the third was egg (18.2%). The presence of atopic dermatitis (AD) and eosinophil count at the time of admission did not affect tolerance development time but it was shown that skin prick test (SPT) positivity and the high level of total IgE at the time of admission delayed the development of tolerance [(p=0.02), (r=0.510, p=0.009)]. Conclusion: Bloody stool is one of the common complaints in infants. It does not always indicate a FA. The clinic is mild when the underlying disease is non-IgE mediated FA. However, accompanying IgE-type sensitivities negatively affect the prognosis. Elevated total IgE and SPT positivity at the time of diagnosis may give an impression that tolerance of baked products could be delayed in this type of allergy.
婴儿带血便:儿科过敏观察
目的:食物过敏(FA)的患病率逐渐上升。便血是婴儿非免疫球蛋白E (IgE)介导的FA相关症状之一。在我们的研究中,我们分享了到我们诊所就诊的带血便患者的临床特征。材料与方法:回顾性分析我院血便患者的临床资料。回顾性记录FA患者的特点及耐受发生时间。结果:回顾了110例患者的档案。68%的患者被诊断为FA(63例为直结肠炎/12例为小肠结肠炎),22%为肛裂,9%为非特异性结肠炎。最常见的致病食物是牛奶(57%),其次是鸡蛋和牛奶的组合(24.2%),第三是鸡蛋(18.2%)。入院时特应性皮炎(AD)和嗜酸性粒细胞计数的存在不影响耐受性的发展时间,但发现入院时皮肤点刺试验(SPT)阳性和高水平的总IgE延迟了耐受性的发展[(p=0.02), (r=0.510, p=0.009)]。结论:便血是婴幼儿常见的主诉之一。它并不总是表示FA。当基础疾病为非ige介导的FA时,临床表现较轻。然而,伴随的ige型敏感性对预后有负面影响。诊断时总IgE和SPT阳性升高可能会给人一种印象,即在这种类型的过敏中,烘焙产品的耐受性可能会延迟。
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