Non-infective colitis in infancy: evidence in favour of minor immunodeficiency in its pathogenesis.
Forty two infants below the age of 2 years presenting with chronic non-infective diarrhoea and shown to have histologically proved colitis were investigated over a five year period. Allergic colitis was the most common cause of colitis, accounting for 62% of the cases. Other colitides diagnosed included: non-specific colitis, autoimmune enterocolitis, and ulcerative colitis accounting for 10% each; severe combined immunodeficiency 7%, and Crohn's disease 3%. A positive family history and a personal history of atopy were obtained in 48% and 29% of the cases respectively. Serum immunoglobulin A, IgG2, and IgG4 were very low in over 50% of the entire cohort of infants with colitis; 66% of those with severe combined immunodeficiency, autoimmune enterocolitis, and ulcerative colitis (n = 11) had low CD3 and CD4 T lymphocytes with an accompanying increase in CD8 in two thirds of those with severe combined immunodeficiency. T lymphocytes were normal in those with allergic colitis. Thus infants with proved non-infective colitis as a group show a high prevalence of IgA, IgG2, and IgG4 deficiency. It is likely that this minor deficiency of mucosa associated immunoglobulin production has a role in the pathogenesis of the colitic process.
Ojuawo
A
A
Gastroenterology Unit, Institute of Child Health, London.
St Louis
D
D
Lindley
K J
KJ
Milla
P J
PJ
D001327:Autoimmune Diseases / Q000276:immunology; D017252:CD3 Complex / Q000032:analysis; D016516:CD4-CD8 Ratio; D002908:Chronic Disease; D003092:Colitis / Q000276:immunology*; D003093:Colitis, Ulcerative / Q000276:immunology; D003424:Crohn Disease / Q000276:immunology; D003967:Diarrhea / Q000276:immunology*; D004406:Dysgammaglobulinemia / Q000150:complications* / Q000276:immunology; D004760:Enterocolitis / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000276:immunology; D017098:IgA Deficiency / Q000150:complications / Q000276:immunology; D017099:IgG Deficiency / Q000150:complications / Q000276:immunology; D018928:Immunity, Mucosal; D007223:Infant; D016511:Severe Combined Immunodeficiency / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
D017252:CD3 Complex