[Allergic colitis in exclusively breast-fed infants].
BACKGROUND
Eosinophilic colitis is induced by antigens present in cow's milk proteins in formula or human milk. In the last few years, an increasing number of cases have been diagnosed in exclusively breast-fed infants.


METHODS
We performed a retrospective study of 13 infants diagnosed with allergic colitis in our unit between January 1997 and January 2004. All the infants had been exclusively breast-fed.


RESULTS
In all patients, initial symptoms were digestive (12 with mucus and bloody stools). Onset of symptoms occurred at 0-3 months in 77 %. Laboratory data of the allergic compound were negative. The main locations were the descending and sigmoid colon (75 %). Biopsy demonstrated acute inflammation, with neutrophil infiltration and an increase in eosinophils. In all patients, initial treatment consisted of exclusion of cow's milk proteins from the mother's diet. Ten of the 13 patients showed no improvement, requiring exclusive administration of protein-free hydrolyzate. In 3 infants, breastfeeding was maintained (breastfeeding without cow's milk proteins plus hydrolyzate).


CONCLUSIONS
Diagnosis of eosinophilic colitis is based on exclusion of other causes of specific colitis and typical endoscopic and ultrastructural findings. Moreover, a satisfactory response to dietary treatment must be demonstrated. This diagnosis should be considered in breast-fed infants with rectal bleeding without involvement of general health status.
Sierra Salinas
C
C
Servicio de Pediatría, Hospital Materno-Infantil, Hospital Regional Universitario Carlos Haya, Málaga, Spain.
Blasco Alonso
J
J
Olivares Sánchez
L
L
Barco Gálvez
A
A
del Río Mapelli
L
L
D001942:Breast Feeding / Q000009:adverse effects*; D003092:Colitis / Q000178:diet therapy / Q000209:etiology* / Q000473:pathology; D004802:Eosinophilia; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000178:diet therapy; D012189:Retrospective Studies