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Advanced Criteria for Clinicopathological Diagnosis of Food Protein-induced Proctocolitis

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Affiliated Author(s)
강유나김상표황진복서성일
Alternative Author(s)
Kang, Yu NaKim, Sang PyoHwang, Jin BokSuh, Seong Il
Journal Title
Journal of Korean Medical Science
ISSN
1011-8934
Issued Date
2007
Keyword
Food protein-induced proctocolitisBreast feedingEndoscopicNodular hyperplasiaHistopathological
Abstract
The clinicopathological findings in previous studies concerning food protein-induced
proctocolitis (FPIPC) are quite diverse in terms of results and conclusions. The aim
of this study was to suggest advanced clinicopathological diagnostic criteria that
facilitate the early confirmation of FPIPC. Data of 38 FPIPC patients, who had received
sigmoidoscopy and biopsy, was analyzed. Microscopic findings were compared
with observations of previous studies. Feeding at onset of bleeding was exclusively
breast-fed (94.7%) and formula-fed or mixed-fed (5.3%). Endoscopic abnormalities
were observed in all patients; nodular hyperplasias with circumscribed and/or
central pit-like erosions in 94.7% and erythema in 5.3%. Histopathological findings
were; lymphoid aggregates in 94.7%, eosinophils in lamina propria of ≥60 cells/10
HPF in 97.4% and of >20 cells/HPF in 63.2%, epithelial or muscularis mucosa eosinophil
infiltration in 97.4%, and crypt abscess in 2.6%. The majority of FPIPC patients
are exclusively breast-fed and nodular hyperplasias with erosions may be a disease
specific endoscopic finding. Histologic diagnosis of FPIPC is compatible with eosinophils
in the lamina propria of ≥60 cells/10 high power fields; however, >20 cells/
HPF is not an appropriate diagnostic criterion.
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