Causes of bloody stools in neonates: a case series report

Lin, Mingchun; Zhu, Haitao; Zhang, Rong; Wang, Huanhuan

doi:10.21037/tp-22-166

Cited by 4 publications

(1 citation statement)

References 37 publications

(54 reference statements)

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“…A multicenter study also showed that the incidence of CMPA was 0.21% in 69,796 hospitalized neonates [14] . Lin et al [15] reported that CMPA allergy was diagnosed in 160 (53.3%) of 300 hospitalized children with bloody stools in the neonatal unit of their hospital, of which 112 (51.1%) were full-term infants and 48 (59.3%) were preterm infants. Pssariello et al [16] analyzed 39 cases of diarrhea in their NICU, of whom 20.5% were caused by food allergy, and Miyazawa et al [17] observed that among 263 NICU infants, 53 cases showed CMPA (with a mean onset age of 6 d) and 41% of them were low-birth-weight infants.…”

Section: Discussionmentioning

confidence: 99%

Different Digestive Tract Complications of Neonatal-Onset Infants with Severe Cow Milk Protein Allergy

Ye,

Geng,

Yang

et al. 2024

Preprint

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The objective of this study was to summarize different digestive tract complications of five neonatal-onset infants with severe cow milk protein allergy (CMPA) to improve early diagnosis, treatment, and prognosis of CMPA. We retrospectively analyzed various digestive tract complications of the five infants who were hospitalized at Guangzhou Women and Children’s Medical Center from July 2016 to June 2020. All five cases were full-term infants, with age at onset ranging from three to 28 days. Three neonates were formula-fed, and two were mixed-fed. The principal clinical manifestations included fever, diarrhea, vomiting, hematochezia, weight loss, edema, and skin ulcers. One infant was diagnosed with necrotizing enterocolitis (NEC) and underwent surgery. Milk-specific IgE was elevated in three cases, and other food-specific IgE antibodies were elevated in two cases. Case 1 revealed severe erosive esophagitis and pyloric stenosis upon gastroscopy; case 2 revealed intestinal lymphatic dilation upon gastroscopy; case 3 showed scattered crater-like ulcers of varying sizes under colonoscopy, with some of the ulcerated tissues around the ulcers showing polypoid changes; case 4 showed ascites of approximately 16 mm in depth upon abdominal ultrasonographic scan; and case 5 depicted colonic stenosis and erosive colitis upon colonoscopy. All five children were cured after receiving either amino acid formula milk (AAF) or extensively hydrolyzed formula (eHF) for enteral nutrition feeding and supportive treatment. Severe CMPA in neonates presented with atypical clinical manifestations, and a variety of complications in various parts of the digestive tract occurred—including inflammation and stenosis—which were easily misdiagnosed as NEC or very-early-onset inflammatory bowel disease (IBD). We posit that early diagnosis will reduce unnecessary operations and shorten treatment time.

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Section: Discussionmentioning

confidence: 99%