Indexes of suspicion of typical cow's milk protein-induced enterocolitis.
This study was performed to identify clinical factors that facilitate the diagnosis of typical cow's milk protein-induced enterocolitis (CMPIE). Data from 142 consecutive patients (aged 15 to 45 days, cow's milk formula- or cow's milk and breast milk mixed-fed) admitted due to vomiting and/or diarrhea were retrospectively analyzed. These 142 subjects were divided into three groups: the CMPIE, infection, and non-infection group. Each group was composed of 16 (11.3%), 102 (71.8%), and 24 (16.9%) patients, respectively. On admission, poor weight gain (p=0.003), hypoalbuminemia (p=0.035), peripheral leukocytosis (p=0.012), and metabolic acidosis (p=0.015) were found to be more significant in the CMPIE group than those in other two groups. In CMPIE, serum albumin levels decreased from 3.3+/-0.9 g/dL on admission to 2.6+/-0.3 g/dL during admission (p<0.05), and methemoglobinemia was observed in 3 patients (18.8%) (p=0.012). Multiple logistic regression analysis showed that the independent predictors of CMPIE versus the infection group were failure to gain weight (OR, 10.75 [95% CI, 1.53-66.12]) (p= 0.014) and hypoalbuminemia (OR, 9.53 [95% CI, 1.62-49.01]) (p=0.010). The early recognition of indexes of suspicion for CMPIE may be of help in the diagnosis and treatment of this disorder.
Hwang
Jin Bok
JB
Department of Pediatrics, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. pedgi@korea.com
Lee
Sung Hyuk
SH
Kang
Yu Na
YN
Kim
Sang Pyo
SP
Suh
Seong Il
SI
Kam
Sin
S
D000138:Acidosis / Q000209:etiology; D000818:Animals; D002417:Cattle; D004760:Enterocolitis / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008708:Methemoglobinemia / Q000209:etiology; D016269:Milk Hypersensitivity / Q000175:diagnosis*; D008894:Milk Proteins / Q000276:immunology*; D012709:Serum Albumin / Q000032:analysis; D015430:Weight Gain
D008894:Milk Proteins; D012709:Serum Albumin