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The etiology of small and fresh rectal bleeding in not-sick neonates: should we initially suspect food protein-induced proctocolitis?

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Author(s)
Hyo-Jeong JangAe Suk KimJin-Bok Hwang
Keimyung Author(s)
Hwang, Jin Bok
Department
Dept. of Pediatrics (소아청소년학)
Journal Title
European Journal of Pediatrics
Issued Date
2012
Volume
171
Issue
12
Abstract
This study was performed to identify the cause
and frequency of food protein-induced proctocolitis (FPIPC)
in not-sick neonates with small and fresh rectal bleeding and
to verify the effectiveness of oral food elimination and
challenge test (ECT) as a diagnostic method of FPIPC. We
prospectively analyzed neonates with small and fresh rectal
bleeding who were clinically normal. We investigated age at
symptom onset, feeding at onset of bleeding, the time of
bleeding disappearance, stool smear and culture, endoscopic
findings, and histopathologies in the biopsy specimens of 16
not-sick neonates. We performed food ECT in cases with
over 4 days of persistent rectal bleeding in the absence of
any other etiology. In 16 not-sick neonates with rectal
bleeding, the median age at symptom onset was 8.5 (1–43)
days. Endoscopic abnormalities were observed in all 16
patients, and in 10 cases satisfying the pathological guidelines
for FPIPC, two (12.5 %) were confirmed as FPIPC by
food ECT. In the other 14 (87.5 %) cases, rectal bleeding
spontaneously disappeared after on average at 4 (1–8) days
and thus was diagnosed as idiopathic neonatal transient
colitis (INTC). Conclusions: FPIPC is rare as a cause of
small and fresh rectal bleeding in not-sick newborns and
most of cases proved to be INTC. Although clinical findings
are suspected as its symptoms and histological results satisfy
its diagnostic criteria, FPIPC should be carefully confirmed
through food ECT.
Keywords Food allergy . Foodprotein-inducedproctocolitis .
Neonate . Rectal bleeding
Keimyung Author(s)(Kor)
황진복
Publisher
School of Medicine
Citation
Hyo-Jeong Jang et al. (2012). The etiology of small and fresh rectal bleeding in not-sick
neonates: should we initially suspect food protein-induced
proctocolitis? European Journal of Pediatrics, 171(12), 1845–1849. doi: 10.1007/s00431-012-1825-2
Type
Article
ISSN
0939-7248
Source
http://lps3.link.springer.com.proxy.dsmc.or.kr/article/10.1007%2Fs00431-012-1825-2
DOI
10.1007/s00431-012-1825-2
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35658
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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