Eosinophilic colitis in infants

Eosinophilic colitis in infants

Alternative title Colite eosinofílica em lactentes
Author Lozinsky, Adriana Chebar Autor UNIFESP Google Scholar
Morais, Mauro Batista de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE:To review the literature for clinical data on infants with allergic or eosinophilic colitis.DATA SOURCE:MEDLINE search of all indexes was performed using the words ''colitis or procto-colitis and eosinophilic'' or ''colitis or proctocolitis and allergic'' between 1966 and February of 2013. All articles that described patients' characteristics were selected.DATA SYNTHESIS:A total of 770 articles were identified, of which 32 met the inclusion criteria. The 32 articles included a total of 314 infants. According to the available information, 61.6% of infants were male and 78.6% were younger than 6 months. Of the 314 patients, 49.0% were fed exclusively breast milk, 44.2% received cow's milk protein, and 6.8% received soy protein. Diarrheal stools were described in 28.3% of patients. Eosinophilia was found in 43.8% (115/263) of infants. Colonic or rectal biopsy showed infiltration by eosinophils (between 5 and 25 perhigh-power field) in 89.3% (236/264) of patients. Most patients showed improvement with theremoval of the protein in cow's milk from their diet or the mother's diet. Allergy challenge tests with cow's milk protein were cited by 12 of the 32 articles (66 patients).CONCLUSIONS:Eosinophilic colitis occurs predominantly in the first six months of life and in males. Allergy to cow's milk was considered the main cause of eosinophilic colitis. Exclusion of cow'smilk from the diet of the lactating mother or from the infant's diet is generally an effective therapeutic measure.

OBJETIVO:Revisão da literatura sobre dados clínicos de lactentes com colite eosinofílica oualérgica.FONTE DOS DADOS:Pesquisa no Medline de todas as indexações com as palavras ''colitis or proc-tocolitis and eosinophilic'' ou ''colitis or proctocolitis and allergic'' entre 1966 e fevereiro de 2013. Foram selecionados todos os artigos que descreviam as características dos pacientes.SÍNTESE DOS DADOS:Foram identificados 770 artigos dos quais 32 preenchiam os critérios de inclusão. Os 32 artigos incluíram o total de 314 lactentes. Conforme as informações disponíveis, 61,6% dos lactentes eram do sexo masculino e 78,6% apresentavam idade inferior a 6 meses. Dos 314 pacientes, 49,0% encontrava-se em aleitamento natural exclusivo, 44,2% recebiam proteína do leite de vaca e 6,8% proteína da soja. Fezes diarreicas foram descritas em 28,3% dos pacientes. Eosinofilia foi encontrada em 43,8% (115/263) dos lactentes. Biópsia retal ou colônica mostrou infiltração por eosinófilos (entre 5 e 25 por campo de grande aumento) em 89,3% (236/264) dos pacientes. A maioria dos pacientes apresentou melhora com a retirada da proteína do leite de vaca da sua dieta ou das suas mães. Teste de desencadeamento com proteína do leite de vaca foi citado em 12 dos 32 artigos (66 pacientes).CONCLUSÕES:Colite eosinofílica ocorre predominantemente nos primeiros seis meses de vida e no sexo masculino. Alergia ao leite de vaca foi considerada a principal causa de colite eosinofílica. Dieta de exclusão do leite de vaca da mãe lactante ou da dieta do lactente é uma medidate rapêutica geralmente eficaz.
Keywords Colitis
Milk hypersensitivity
Eosinophils
Infant
Colite
Alergia a leite
Eosinofilos
Lactente
Language English
Date 2014-01-01
Published in Jornal de Pediatria. Sociedade Brasileira de Pediatria, v. 90, n. 1, p. 16-21, 2014.
ISSN 0021-7557 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Pediatria
Extent 16-21
Origin http://dx.doi.org/10.1016/j.jped.2013.03.024
Access rights Open access Open Access
Type Article
SciELO ID S0021-75572014000100016 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/8162

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