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- W2129304888 abstract "Background: Allergic proctocolitis is the most common cause of rectal bleeding in infants, with a mean age of diagnosis of 66 days (range 4-304 days). In most cases exposure to the antigen occurs after birth. However, as has been reported in preterm infants less than 1 week old, the sensitization may also occur intrautero. We report here 2 full-term infants with bloody stools in the first 28 hrs. of life. Methods and results:Case 1: Full term infant with current jelly stool 7 minutes after an uncomplicated delivery, following meconium passage. The baby was never fed. In the NICU, necrotizing enterocolitis (NEC), infectious colitis, and sepsis were ruled out. On day 3 of life, a proctosigmoidoscopy (PS) demonstrated a friable and erythematous mucosa, with discrete lymphonodular hyperplasia. Histology showed mild, chronic non-specific inflammation with > 40 cosinophils per 40x, some degranulating. Feeds were started after 1 day of IV steroids, on DOL #5 with casein hydrolysate based formula with good tolerance. After a 2-week course of oral steroids the baby was thriving on a milk-protein free diet 8 months later. Case 2: Full term baby with grossly bloody stools at 28 hr of life, after eating cow's milk based formula. Infectious colitis, NEC, and sepsis were ruled out. On DOL #2 he began casein hydrolysate based formula, and PS on DOL #4 demonstrated very friable mucosa with erythema. Histology was similar to case 1. At 8 months, he was thriving on a milk-free diet. Conclusion: Allergic colitis can occur in the first 48 hours of life, and is a diagnostic consideration in the full-term newborn with bloody stools. We believe that milk-protein was the allergen in both infants, though definitive proof would have required a risky rechallenge. Sensitization must occur intrautero, and bloody stool can develop without exposure to enteral feeding." @default.
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- W2129304888 date "1997-10-01" @default.
- W2129304888 modified "2023-09-26" @default.
- W2129304888 title "ALLERGIC COLITIS PRESENTING IN THE FIRST 28 HOURS OF LIFE: A REPORT OF 2 CASES" @default.
- W2129304888 doi "https://doi.org/10.1097/00005176-199710000-00138" @default.
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