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Lymphoid nodular hyperplasia and cow's milk hypersensitivity in children with chronic constipation.
J Pediatr 2004; 145(5):606-11JPed

Abstract

OBJECTIVE

To investigate the incidence of cow's milk allergy as evidenced by milk challenge and the findings of endoscopic and immunohistochemical examinations in children with chronic and refractory constipation.

STUDY DESIGN

Thirty-five study subjects (mean age, 8.3 +/- 3.3 years; range, 3-15 years; 17 girls) and 15 control subjects (mean age, 11.7 +/- 3.2 years; range, 2-15 years; 9 girls) were studied by colonoscopy and a 4-week cow's milk elimination and challenge.

RESULTS

Lymphoid nodular hyperplasia was the most prominent endoscopic finding in half of the subjects (46%), mostly occurring patchily in the transverse colon. Histologic findings other than lymphoid accumulation and mildly increased density of eosinophils were few. During the milk elimination and with supportive medication, 83% of subjects remitted. Constipation and/or other gastrointestinal or skin symptoms relapsed only in one third (34%) during the cow's milk challenge, these having significantly higher densities of intraepithelial gammadelta + T cells (P <.001) in the biopsy samples of the terminal ileum as compared with the control subjects.

CONCLUSIONS

We were able to find formal evidence for the presence of cow's milk allergy in children with chronic constipation.

Authors+Show Affiliations

Department of Pediatrics, University Hospital Oulu, Finland.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15520758

Citation

Turunen, Sami, et al. "Lymphoid Nodular Hyperplasia and Cow's Milk Hypersensitivity in Children With Chronic Constipation." The Journal of Pediatrics, vol. 145, no. 5, 2004, pp. 606-11.
Turunen S, Karttunen TJ, Kokkonen J. Lymphoid nodular hyperplasia and cow's milk hypersensitivity in children with chronic constipation. J Pediatr. 2004;145(5):606-11.
Turunen, S., Karttunen, T. J., & Kokkonen, J. (2004). Lymphoid nodular hyperplasia and cow's milk hypersensitivity in children with chronic constipation. The Journal of Pediatrics, 145(5), pp. 606-11.
Turunen S, Karttunen TJ, Kokkonen J. Lymphoid Nodular Hyperplasia and Cow's Milk Hypersensitivity in Children With Chronic Constipation. J Pediatr. 2004;145(5):606-11. PubMed PMID: 15520758.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymphoid nodular hyperplasia and cow's milk hypersensitivity in children with chronic constipation. AU - Turunen,Sami, AU - Karttunen,Tuomo J, AU - Kokkonen,Jorma, PY - 2004/11/3/pubmed PY - 2004/12/17/medline PY - 2004/11/3/entrez SP - 606 EP - 11 JF - The Journal of pediatrics JO - J. Pediatr. VL - 145 IS - 5 N2 - OBJECTIVE: To investigate the incidence of cow's milk allergy as evidenced by milk challenge and the findings of endoscopic and immunohistochemical examinations in children with chronic and refractory constipation. STUDY DESIGN: Thirty-five study subjects (mean age, 8.3 +/- 3.3 years; range, 3-15 years; 17 girls) and 15 control subjects (mean age, 11.7 +/- 3.2 years; range, 2-15 years; 9 girls) were studied by colonoscopy and a 4-week cow's milk elimination and challenge. RESULTS: Lymphoid nodular hyperplasia was the most prominent endoscopic finding in half of the subjects (46%), mostly occurring patchily in the transverse colon. Histologic findings other than lymphoid accumulation and mildly increased density of eosinophils were few. During the milk elimination and with supportive medication, 83% of subjects remitted. Constipation and/or other gastrointestinal or skin symptoms relapsed only in one third (34%) during the cow's milk challenge, these having significantly higher densities of intraepithelial gammadelta + T cells (P <.001) in the biopsy samples of the terminal ileum as compared with the control subjects. CONCLUSIONS: We were able to find formal evidence for the presence of cow's milk allergy in children with chronic constipation. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/15520758/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(04)00633-X DB - PRIME DP - Unbound Medicine ER -