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首页> 外文期刊>American Journal of Perinatology Reports >Hematochezia before the First Feeding in a Newborn with Food Protein-Induced Enterocolitis Syndrome
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Hematochezia before the First Feeding in a Newborn with Food Protein-Induced Enterocolitis Syndrome

机译：首次进食具有食物蛋白诱发的小肠结肠炎综合征的新生儿之前的便血

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摘要

The prevalence and incidence of food protein-induced enterocolitis syndrome (FPIES) are clearly not known; its onset before first feeding at birth especially has been rarely reported. A female newborn was referred to our institution due to blood-stained diarrhea before her first feeding at birth. Examination of the stool with Wright-Giemsa staining on day 6 revealed numerous fecal eosinophils, including Charcot-Leyden crystals. Lymphocyte stimulation test (LST) against cow's milk protein also showed positive values on day 12. The hematochezia resolved immediately after starting intravenous nutrition. She was fed with breast milk and extensively hydrolyzed formula and discharged from hospital on day 49. FPIES was diagnosed based on these symptoms and data. Our case was thought to have acquired allergic enterocolitis after sensitization in her fetal period, which caused severe FPIES triggered by the first intake of cow's milk soon after birth. The patient with FPIES presents atypical clinical findings, which is likely to cause misdiagnosis and delay of appropriate treatment. Heightened awareness and increased attention may be necessary to diagnose FPIES, even soon after birth. Evaluating fecal eosinophils and LST, which may be difficult to perform in every clinical hospital, is thought to be useful for the detection of FPIES without oral food challenge.
机译：食物蛋白诱导的小肠结肠炎综合征（FPIES）的患病率和发病率尚不清楚。尤其是在出生时首次进食之前开始发病。一名女新生儿在刚出生时就因血染性腹泻而被转诊到我们的机构。在第6天用赖特-吉姆萨染色对粪便进行检查，结果发现粪便中有许多嗜酸性粒细胞，包括夏科-莱登晶体。第12天，针对牛奶蛋白的淋巴细胞刺激试验（LST）也显示阳性值。开始静脉营养后，便血立即消失。给她喂了母乳和大量水解的配方奶，并在第49天出院。根据这些症状和数据，对FPIES进行了诊断。我们的病例被认为是在胎儿期致敏后获得了过敏性小肠结肠炎，这导致严重的FPIES是由出生后不久就首次摄入牛奶引起的。 FPIES患者表现出非典型的临床表现，这很可能导致误诊和适当治疗的延迟。诊断FPIES，即使在出生后不久，也可能需要提高认识并增加注意力。粪便嗜酸性粒细胞和LST的评估可能在每家临床医院都很难进行，被认为可用于检测FPIES而无需口服食物刺激。

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