Gastrointestinal Manifestations of Cow's Milk Protein Allergy During the First Year of Life
PHISEK YIMY AEM, MD*, VORANUSH CHONGSRISAWAT, MD*, BOOSBA VIVA TV AKIN, MD*, NARUEMON WISEDOPAS, MD**
Affiliation : *Gastroenterology Division, Department of Pediatrics, **Department of Pathology, Faculty of Medicine, Chulalongkom University, Bangkok 10330, Thailand.
Method :The authors reviewed the records of 10 CMPSE patients observed by the Gastro intestinal Unit at King Chulalongkorn Memorial Hospital from 1997-200 I including patient charac teristics, laboratory investigations, endoscopy and follow-up outcome.
Results : Of 10 CMPSE patients, the median age of CMPSE onset was 3.5 months. The gastrointestinal manifestations were hematemesis (n = 6), mucous bloody diarrhea (n = 3) and chronic watery diarrhea (n = 2). Exclusively breast-fed infants seemed to have more delayed onset of symp toms than those who were not. Anemia (n = 3), high serum IgE (n = 4) and positive skin prick test for cow's milk (n = 5) were found. Neither peripheral eosinophilia nor hypoalbuminemia was found. Endoscopy revealed acute and chronic gastritis. Treatment was successful by changing to soy or exten sive hydrolysate formula with mean duration of cow's milk intolerance of 24 months. In 2-year follow-up, three of ten patients who had high serum lgE level developed allergic rhinitis and eczema.
Conclusion : CMPSE can be manifested in various symptoms. Exclusive breast feeding for more than 4 months can postpone the onset of CMPSE. Serum lgE or specific lgE level to cow's milk protein may identify the atopic career of CMPSE individuals.
Keywords : Cow's Milk Protein Allergy, Infant, Gastrointestinal Manifestation
