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[Cow's milk protein allergy after neonatal intestinal surgery].
Arch Pediatr. 2005 Feb; 12(2):134-9.AP

Abstract

Cases of cow's milk protein allergy have been occasionally reported after neonatal intestinal surgery.

AIM OF THE STUDY

To measure the prevalence of cow's milk protein allergy (CMPA) following neonatal intestinal surgery.

PATIENTS AND METHODS

The files of all children who underwent intestinal surgery in the neonatal period over a four-year-period were reviewed. The diagnosis of CMPA was made on the association of one or several symptoms suggesting food allergy after the introduction of cow's milk protein in the diet, the disappearance of the symptoms after exclusion of cow's milk protein from the diet and their reappearance after reintroduction of cow's milk protein.

RESULTS

During the study period, 251 neonates underwent an intestinal surgery. Among them, 11 babies (4.3%) developed CMPA. None of them had a medical history of family atopy. Moreover, while 5 children were fed with a diet containing cow's milk protein before surgery: none of them presented initially with symptoms suggesting CMPA before intestinal surgery. Small intestine suffering was observed during operation in seven of 11 patients. No specific neonatal digestive disease or malformation was associated with CMPA. The signs revealing CMPA were primarily digestive : diarrhoea (N =3), vomiting (N =4), abdominal distension (N =2), colic or anorexia (N =2). Casein specific immunoglobulin E were present in nine of ten cases, alpha lactalbumin and/or beta lactoglobulin specific immunoglobulin E were present in six of ten cases. Prick test were performed in three children and were positive.

CONCLUSION

The high prevalence of CMPA among these patients with no risk factors of allergy raises the question of the role of neonatal intestinal surgery in developing food allergy. These data should be confirmed by prospective case-control studies. They underline the interest to evoke the diagnosis of CMPA when digestive symptoms occur after milk protein introduction in children undergoing neonatal intestinal surgery. Breast feeding or milk protein hydrolysate formula should be used for refeeding these patients.

Authors+Show Affiliations

Unité de gastroentérologie, hépatologie et nutrition, clinique de pédiatrie, clinique de chirurgie infantile, hôpital Jeanne-de-Flandre, et faculté de médecine, 59037 Lille cedex, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

15694535

Citation

El Hassani, A, et al. "[Cow's Milk Protein Allergy After Neonatal Intestinal Surgery]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 12, no. 2, 2005, pp. 134-9.
El Hassani A, Michaud L, Chartier A, et al. [Cow's milk protein allergy after neonatal intestinal surgery]. Arch Pediatr. 2005;12(2):134-9.
El Hassani, A., Michaud, L., Chartier, A., Penel-Capelle, D., Sfeir, R., Besson, R., Turck, D., & Gottrand, F. (2005). [Cow's milk protein allergy after neonatal intestinal surgery]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 12(2), 134-9.
El Hassani A, et al. [Cow's Milk Protein Allergy After Neonatal Intestinal Surgery]. Arch Pediatr. 2005;12(2):134-9. PubMed PMID: 15694535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Cow's milk protein allergy after neonatal intestinal surgery]. AU - El Hassani,A, AU - Michaud,L, AU - Chartier,A, AU - Penel-Capelle,D, AU - Sfeir,R, AU - Besson,R, AU - Turck,D, AU - Gottrand,F, PY - 2004/01/26/received PY - 2004/10/12/accepted PY - 2005/2/8/pubmed PY - 2005/3/30/medline PY - 2005/2/8/entrez SP - 134 EP - 9 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 12 IS - 2 N2 - UNLABELLED: Cases of cow's milk protein allergy have been occasionally reported after neonatal intestinal surgery. AIM OF THE STUDY: To measure the prevalence of cow's milk protein allergy (CMPA) following neonatal intestinal surgery. PATIENTS AND METHODS: The files of all children who underwent intestinal surgery in the neonatal period over a four-year-period were reviewed. The diagnosis of CMPA was made on the association of one or several symptoms suggesting food allergy after the introduction of cow's milk protein in the diet, the disappearance of the symptoms after exclusion of cow's milk protein from the diet and their reappearance after reintroduction of cow's milk protein. RESULTS: During the study period, 251 neonates underwent an intestinal surgery. Among them, 11 babies (4.3%) developed CMPA. None of them had a medical history of family atopy. Moreover, while 5 children were fed with a diet containing cow's milk protein before surgery: none of them presented initially with symptoms suggesting CMPA before intestinal surgery. Small intestine suffering was observed during operation in seven of 11 patients. No specific neonatal digestive disease or malformation was associated with CMPA. The signs revealing CMPA were primarily digestive : diarrhoea (N =3), vomiting (N =4), abdominal distension (N =2), colic or anorexia (N =2). Casein specific immunoglobulin E were present in nine of ten cases, alpha lactalbumin and/or beta lactoglobulin specific immunoglobulin E were present in six of ten cases. Prick test were performed in three children and were positive. CONCLUSION: The high prevalence of CMPA among these patients with no risk factors of allergy raises the question of the role of neonatal intestinal surgery in developing food allergy. These data should be confirmed by prospective case-control studies. They underline the interest to evoke the diagnosis of CMPA when digestive symptoms occur after milk protein introduction in children undergoing neonatal intestinal surgery. Breast feeding or milk protein hydrolysate formula should be used for refeeding these patients. SN - 0929-693X UR - https://www.unboundmedicine.com/medline/citation/15694535/[Cow's_milk_protein_allergy_after_neonatal_intestinal_surgery]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(04)00559-7 DB - PRIME DP - Unbound Medicine ER -