Proctocolitis in exclusively breast-fed infants. 1996

L Anveden-Hertzberg, and Y Finkel, and B Sandstedt, and B Karpe
Department of Paediatric Surgery, St. Göran's Hospital, Stockholm, Sweden.

We present nine exclusively breast-fed, full-term infants with mild rectal bleeding due to proctocolitis. The mean age at the onset of symptoms was 5 weeks (range 1-8 weeks). Rectosigmoidoscopic examination was performed in all the children within 2 days after admission, showing inflammatory changes such as oedematous mucosa with petechial haemorrhages. Rectal mucosal biopsy specimens were obtained in eight cases and revealed intra-epithelial eosinophilic granulocytes in seven and a diffuse increase of eosinophils in the lamina propria in six. Allergy to cow's milk protein transferred to the infants via the breast milk was believed to be the cause of the inflammation. The intake of cow's milk protein was then restricted in seven mothers. Following this regimen, symptoms were relieved within 4 weeks in the six infants who were seen at follow up. One child recovered spontaneously without dietary restrictions. Considering the beneficial effect of the diet regimen in addition to the histological findings, allergy to cow's milk protein is possibly the aetiology of the proctocolitis seen in these nine exclusively breast-fed babies, although no challenge tests were performed to confirm this suspicion. CONCLUSIONS This report shows that proctocolitis occurs in exclusively breast-fed infants. It is speculated that allergy to cow's milk protein may have played a role in the pathogenesis.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007413 Intestinal Mucosa Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI. Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008297 Male Males
D011350 Proctocolitis Inflammation of the RECTUM and the distal portion of the COLON. Proctocolitis, Hemorrhagic,Proctocolitis, Ulcerative,Proctosigmoiditis,Rectocolitis,Rectocolitis, Hemorrhagic,Rectocolitis, Ulcerative,Rectosigmoiditis,Hemorrhagic Proctocolitis,Ulcerative Proctocolitis,Hemorrhagic Rectocolitis,Proctocolitides, Ulcerative,Rectocolitides, Ulcerative,Ulcerative Proctocolitides,Ulcerative Rectocolitides,Ulcerative Rectocolitis
D011351 Proctoscopy Endoscopic examination, therapy or surgery of the RECTUM; ANAL CANAL; and ANUS. Anoscopic Examination,Anoscopy,Proctoscopic Surgical Procedures,Rectoscopy,Surgical Procedures, Proctoscopic,Proctoscopic Surgery,Surgery, Proctoscopic,Anoscopic Examinations,Anoscopies,Examination, Anoscopic,Examinations, Anoscopic,Procedure, Proctoscopic Surgical,Procedures, Proctoscopic Surgical,Proctoscopic Surgeries,Proctoscopic Surgical Procedure,Proctoscopies,Rectoscopies,Surgeries, Proctoscopic,Surgical Procedure, Proctoscopic
D001942 Breast Feeding The nursing of an infant at the breast. Breast Fed,Breastfed,Milk Sharing,Wet Nursing,Breast Feeding, Exclusive,Breastfeeding,Breastfeeding, Exclusive,Exclusive Breast Feeding,Exclusive Breastfeeding,Sharing, Milk
D002417 Cattle Domesticated bovine animals of the genus Bos, usually kept on a farm or ranch and used for the production of meat or dairy products or for heavy labor. Beef Cow,Bos grunniens,Bos indicus,Bos indicus Cattle,Bos taurus,Cow,Cow, Domestic,Dairy Cow,Holstein Cow,Indicine Cattle,Taurine Cattle,Taurus Cattle,Yak,Zebu,Beef Cows,Bos indicus Cattles,Cattle, Bos indicus,Cattle, Indicine,Cattle, Taurine,Cattle, Taurus,Cattles, Bos indicus,Cattles, Indicine,Cattles, Taurine,Cattles, Taurus,Cow, Beef,Cow, Dairy,Cow, Holstein,Cows,Dairy Cows,Domestic Cow,Domestic Cows,Indicine Cattles,Taurine Cattles,Taurus Cattles,Yaks,Zebus
D005260 Female Females
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias

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