Allergic Proctocolitis Resembling Ulcerative Colitis of Infancy in a 3-day Old Neonate
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Allergic proctocolitis (AP) can be hard to differentiate and diagnose in neonates who manifested watery diarrhea and failure to thrive. The initial symptoms are not specific and colonoscopic findings share similar ulcerated and erythematous lesions as in ulcerative colitis of infancy and infectious colitis. A 3-day-old infant was admitted to the hospital due to loose, blood-tinged stools. An initial workup, including abdominal ultrasound and hepatobiliary scan, was performed, and all results were negative. The patient subsequently required readmission due to pervasive watery diarrhea, severe weight loss, and lethargy. After further investigation, he was eventually diagnosed of allergic proctocolitis by rectosigmoidoscopy and biopsy. Treatment was started with a corticosteroid (prednisone 2 mg/kg/day) due to severe symptoms. After 7 days of steroid therapy, the stools slowly normalized, and the patient started to gain weight. He was discharged home and followed regularly at the outpatient clinic.
Abstract
Allergic proctocolitis (AP) can be hard to differentiate and diagnose in neonates who manifested watery diarrhea and failure to thrive. The initial symptoms are not specific and colonoscopic findings share similar ulcerated and erythematous lesions as in ulcerative colitis of infancy and infectious colitis. A 3-day-old infant was admitted to the hospital due to loose, blood-tinged stools. An initial workup, including abdominal ultrasound and hepatobiliary scan, was performed, and all results were negative. The patient subsequently required readmission due to pervasive watery diarrhea, severe weight loss, and lethargy. After further investigation, he was eventually diagnosed of allergic proctocolitis by rectosigmoidoscopy and biopsy. Treatment was started with a corticosteroid (prednisone 2 mg/kg/day) due to severe symptoms. After 7 days of steroid therapy, the stools slowly normalized, and the patient started to gain weight. He was discharged home and followed regularly at the outpatient clinic.
참고문헌 (12)
- 이주희, "알레르기성 직결장염의 임상상과 내시경 및 조직소견", Korean Journal of Pediatrics, 51(3), pp.276~285 (2008), 대한소아과학회
- Arvola T, "Rectal bleeding in infancy: clinical, allergological, and microbiological examination", Pediatrics, 117, pp.760~768 (2006)
- Cannioto Z, "IBD and IBD mimicking enterocolitis in children younger than 2 years of age", Eur J Pediatr, 168, pp.149~155 (2009)
- Marx G, "Outcome of Crohn’s disease diagnosed before two years of age", J Pediatr, 140, pp.470~473 (2002)
- Ruemmele FM, "Characteristics of inflammatory bowel disease with onset during the first year of life", J Pediatr Gastroenterol Nutr, 43, pp.603~609 (2006)
- Hildebrand H, "Changing pattern of pediatric inflammatory bowel disease in northern Stockholm 1990-2001", Gut, 52, pp.1432~1434 (2003)
- Kliegman RM, "Nelson textbook of pediatrics", pp.1295~1300 (2011), Elsevier Saunders
- Thapar N, "Long-term outcome of intractable ulcerating enterocolitis of infancy", J Pediatr Gastroenterol Nutr, 40, pp.582~588 (2005)
- Kleinman R, "Walker’s pediatric gastrointestinal disease", pp.519~543 (2008), BC Decker Inc.
- Yang SK, "Epidemiology of inflammatory bowel disease in Asia", Inflamm Bowel Dis, 7, pp.260~270 (2001)
- Turner D, "Consensus for managing acute severe ulcerative colitis in children: a systematic review and joint statement from ECCO, ESPGHAN, and the Porto IBD working group of ESPGHAN", Am J Gastroenterol, 106, pp.574~588 (2011)
- Heine RG, "Pathophysiology, diagnosis and treatment of food protein-induced gastrointestinal diseases", Curr Opin Allergy Clin Immunol, 4, pp.221~229 (2004)
