Cow's milk intolerance with melena

Kokkonen, Jorma; Similä, S

doi:10.1007/bf00441640

Cited by 8 publications

(5 citation statements)

References 20 publications

(15 reference statements)

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“…inant upper involvement (16) or variable degrees of colitis (10,17,18), whereas most of them have small intestinal damage manifested as chronic diarrhea and malabsorption (5)(6)(7)(8)(9)12,19). The patients we are describing seem to belong to the group of predominant upper GI involvement presenting with vomiting, erosive gastritis, duodenitis, and impaired Dxylose absorption as an indicator of proximal jejunal damage.…”

Section: Discussionmentioning

confidence: 87%

Gastrointestinal Occult Hemorrhage and Gastroduodenitis in Cow's Milk Protein Intolerance

Coello‐Ramirez,

Larrosa‐Haro

1984

J. pediatr. gastroenterol. nutr.

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We are reporting on four infants with cow's milk protein intolerance who presented with hypochromic anemia and occult gastrointestinal hemorrhage. Esophagogastroduodenoscopy revealed erosive gastritis or gastroduodenitis in all cases. Management with a cow's milk‐free diet led to a favorable clinical and hematological outcome; the endoscopic inflammatory image disappeared after the cow's milk‐free diet trial. Challenge with cow's milk led to gastrointestinal symptoms and to impaired D‐xylose absorption. The data presented suggest that some patients with cow's milk intolerance may have gastroduodenitis resulting in occult gastrointestinal hemorrhage and hypochromic anemia.

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Section: Discussionmentioning

confidence: 87%

Gastrointestinal Occult Hemorrhage and Gastroduodenitis in Cow's Milk Protein Intolerance

Coello‐Ramirez,

Larrosa‐Haro

1984

J. pediatr. gastroenterol. nutr.

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“…The lesion in ICMA is widespread, often being present from stornach to rectum. The severity of the lesion varies in different parts of the gastrointestinal tract: some infants have severe jejunal damage with no colonic involvement whereas others show predominantly colonic lesion (9,21,26).…”

Section: Morphologie Lesion In the Gastrointestinal Traet In Icmamentioning

confidence: 99%

“…In sigmoidoscopy the mucosa is red and ulc~rated. Microscopic studies show destruction of the surface epithelium, crypt abscesses and distention of the rectal glands (24,26). Sigmoidoscopy shows that the mucosa reverts to normal within two days of elimination of CM from the diet (26).…”

Section: Morphologie Lesion In the Gastrointestinal Traet In Icmamentioning

confidence: 99%

Intestinal Cow's Milk Allergy

Kuitunen¹,

Savilahti²,

Verkasalo³

1985

Klin Padiatr

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Cow's milk allergy (CMA) is multifaceted disease representing systemic, skin or gastrointestinal reactions to cow's milk (CM) protein. This article shortly reviews the intestinal form of CMA (ICMA). According us the child is allergic to CM when the immunologic reaction to CM is associated with clinical symptoms. The incidence of CMA is 1.3-1.9% in general, but the ICMA only 0.6 pro mille among the children less than six months of age. The majority of infants shows symptoms within a month of starting CM feeding. The majority of children with CMA have gastrointestinal symptoms. Manx of these infants has additionally dermatological symptoms and some respiratory symptoms. The mode of onset is often acute diarrhoea and vomiting, as in acute gastroenteritis. Laboratory findings indicate iron deficiency anemia in 20-70%. Half to two thirds of infants with chronic diarrhoea have moderate to severe steatorrhoea. The morphologic lesion in the gastrointestinal tract in ICMA is widespread, often being present from stomach to rectum. Jejunal lesion is most severe in the proximal part of the intestine and nowadays most patients have only partial villous atrophy or slight changes of the villi. Both the epithelium and the lamina propria of the jejunum are infiltrated with inflammatory cells. The morphology of the small intestine speaks for a strong immune reaction which leads increased destruction of surface epithelial cells. We recommend elimination of CM proteins to the age of 1.5 to 2 years. Most patients tolerate CM by the age of 2 years without symptoms. Prolonged breast-feeding and avoidance of early contact with CM are important in reducing the severity and frequency of CMA.

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“…Intraepithelial lymphocytes (IEL) constitute the first immune cell line of defence in the intestine. Increased density of these cells on the duodenal mucosa is considered to be associated with enhanced cell-mediated immune response and is typically related to food hypersensitivities (1)(2)(3)(4). Though the exact pathogenetic role of IEL cells remains unresolved, it is clear that they are implicated in inflammatory autoimmune and hypersensitivity conditions (5,6).…”

mentioning

confidence: 99%