allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants a clinical observation过敏proctocolitis耐火孕产妇低变应原的饮食完全母乳喂养的婴儿的临床观察.pdfVIP

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allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants a clinical observation过敏proctocolitis耐火孕产妇低变应原的饮食完全母乳喂养的婴儿的临床观察.pdf

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allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants a clinical observation过敏proctocolitis耐火孕产妇低变应原的饮食完全母乳喂养的婴儿的临床观察

Lucarelli et al. BMC Gastroenterology 2011, 11:82 /1471-230X/11/82 RESEARCH ARTICLE Open Access Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation 1*† 1† 1† 1† 3 Sandra Lucarelli , Giovanni Di Nardo , Ginevra Lastrucci , Ylenia D’Alfonso , Adriana Marcheggiano , Tatiana Federici 1†, Simone Frediani1†, Tullio Frediani2† and Salvatore Cucchiara1† Abstract Background: Allergic proctocolitis (APC) in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT) could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization. Additionally, we assessed the efficacy of an amino acid-based formula (AAF) when multiple food allergy is suspected. amino acid-based formula Methods: We have prospectively enrolled 14 exclusively breast-fed infants with APC refractory to maternal allergen avoidance. The diagnosis was confirmed by endoscopy with biopsies. Skin prick tests and serum specific IgE for common foods, together with APTs for common foods plus breast milk, were performed. After a 1 month therapy of an AAF all patients underwent a follow-up rectosigmoidoscopy. Results: Prick tests and serum specific IgE were negative. APTs were positive in 100% infants, with a multiple positivity in 50%. Sensitization was found for breast milk in 100%, cow’s milk (50%), soy (28%), egg (21%), rice (14%