Intolerance to an extensively hydrolysed formula mistaken for postoperative diarrhoea in a child with neuroblastoma.
BACKGROUND
Persistent diarrhoea has recently been reported as a common problem following surgical resection for advanced abdominal neuroblastoma.


METHODS
A 10-month-old child, who had previously had no nutritional problems whilst undergoing chemotherapy treatment for a stage IV neuroblastoma, developed severe diarrhoea following tumour resection. He required nutritional support and was commenced on a continuous overnight nasogastric feed of a non-milk protein hydrolysate feed (MCT Pepdite 0-2, S.H.S. International Ltd, UK) His diarrhoea persisted and it was assumed that this was a postoperative problem which in time would regress. Two months later the child was admitted with a rectal prolapse, and a colonoscopy and biopsy suggested allergic protocolitis. The diarrhoea resolved rapidly on stopping the feed.


CONCLUSIONS
Although he was never re-challenged with the non-milk protein hydrolysate, it appears that he had a rare intolerance to an extensively hydrolysed protein formula which was masked by the assumption that his diarrhoea was a postoperative problem.
Ward
E
E
Dietetic Department, St James's University Hospital, Leeds, UK.
Picton
S
S
D000008:Abdominal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003106:Colon / Q000473:pathology; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology*; D004750:Enteral Nutrition / Q000009:adverse effects; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects*; D008297:Male; D009447:Neuroblastoma / Q000188:drug therapy / Q000601:surgery*; D011184:Postoperative Period; D013025:Glycine max / Q000009:adverse effects