The Significance of Gastric Juice Analysis for a Positive Challenge by a Standard Oral Challenge Test in Typical Cow's Milk Protein-Induced Enterocolitis.
10.3346/jkms.2008.23.2.251
- Author:
Jin Bok HWANG
1
;
Jeong Yoon SONG
;
Yu Na KANG
;
Sang Pyo KIM
;
Seong Il SUH
;
Sin KAM
;
Won Joung CHOI
Author Information
1. Department of Pediatrics, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. pedgi@kmu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Food Hypersensitivity;
Cow's Milk Protein-Induced Enterocolitis;
Oral Challenge;
Diagnostic Criteria;
Gastric Juice Analysis
- MeSH:
Adolescent;
Adult;
Algorithms;
Animals;
Blood Cell Count;
C-Reactive Protein/analysis;
Cattle;
Enterocolitis/*diagnosis/*etiology;
Female;
*Gastric Juice;
Humans;
Male;
Milk Hypersensitivity/*diagnosis/*pathology;
Milk Proteins/*analysis;
Neutrophils/cytology
- From:Journal of Korean Medical Science
2008;23(2):251-255
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study was performed to investigate the significance of gastric juice analysis (GJA) as a diagnostic criterion of a positive challenge in a standard oral cow's milk challenge (OCC) to confirm typical cow's milk protein-induced enterocolitis (CMPIE). Data from 16 CMPIE patients (aged 14 to 44 days) were analyzed. A standard OCC was openly executed using 0.15 g/kg of protein. Three symptoms (vomiting, lethargy, and bloody or pus-like stool), and four laboratory findings (GJA [3 hr], changes in peripheral blood absolute neutrophil count [ANC] [6 hr], C-reactive protein [6 hr], and stool smear test for occult blood or leukocytes) were observed after OCC. Before OCC, baseline studies were conducted; a stool smear test, blood sampling, and GJA. Positive OCC results were; vomiting (87.5%) (observed 1-3 hr after OCC), lethargy (62.5%) (1-3 hr), bloody or pus-like stool (43.8%) (6-10 hr), abnormal GJA (93.8%), an ANC rise >3,500 cells/microliter (93.8%), and an abnormal stool smear test (75.0%). A single GJA test after a standard OCC is a sensitive diagnostic criterion of a positive challenge, and may provide an early confirmatory diagnosis of CMPIE. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in CMPIE.
