Автор:
Novikova V.P., Bogdanova N.M., Prokopyeva N., Lapin S.V., Kuznetsova D.A., Vorontsov P.
Год:
2019
Файл:
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Публикация: Archives of Disease in Childhood. 2019. 104(Suppl 3):A21.2-A21.
Ключевые слова: secondary lactose intolerance
Аннотация
Introduction: Cow’s milk protein allergy (CMPA) is one of the causes of secondary lactose intolerance (SLI) in infants.
The aim: To determine the possibility of faecal tests: calprotectin, ECP and hidden blood in the stool for the diagnosis of
gastrointestinal manifestations of CMPA in infants with SLI.
gastrointestinal manifestations of CMPA in infants with SLI.
Patients and methods: 30 children, aged from 1 to 5 months, full-term born, suffering from infantile colic and gastrointestinal disorders due to lactose intolerance, confirmed by FOG test the background of cow’s milk protein intolerance, were observed. 63.33% of children were breastfed, 36.67% were mixed, received medical infant formula.CMPA in examined participants was diagnosed based on recommendations of EAACI (2014) and CoMiSS scale. SLI was confirmed by FOG, which was carried out by spectrophotometric measurement of the concentration of Na + and K + ions. Calprotectin and ECP in the stool were determined by ELISA. To detectthe hidden blood in the stool,out-of-point «Colon View» test was used. The control group consisted of 10 healthy similar aged, breastfed infants. Statistical analysis was carry out using Stat Soft Statistica 12.0. for Windows-10.
Results Participating children suffered from colic in 86.67%, regurgitation in 56.67%, diarrhea in83.33%, ishesion in 46.67%, constipation in 13.33%, blood streaks in thestool in 13.33%, atopic dermatitisin 73.33%. All had a combination of
two or more gastrointestinal disorders. The average level of FOG in CMPA was higher than in healthy ones (204.94 ± 23.56 Osmol/kg. And 116.52 ± 65.8 Osmol/kg; P <0.001). Average values of calprotectin (463.89 ± 281.4 mg/g and 204.45 ± 190.29 mg/g; p>0.05) and ECP (2053.13 ± 1236.61ng/ml and 1258.88 ± 1012, 80 ng/ml) didn’t differ in both groups, however, the frequency of elevated ECP levels was higher in the group of CMPA (63% and 30%, p <0.05). And the blood in the stool was detected more often(22.2% and 0%, p <0.05). The correlation between the levels of calprotectin and ECP (r = 0.55, p <0.05) and between the levels of FOG and ECP (r = 0.37, p<0.05) was found.
two or more gastrointestinal disorders. The average level of FOG in CMPA was higher than in healthy ones (204.94 ± 23.56 Osmol/kg. And 116.52 ± 65.8 Osmol/kg; P <0.001). Average values of calprotectin (463.89 ± 281.4 mg/g and 204.45 ± 190.29 mg/g; p>0.05) and ECP (2053.13 ± 1236.61ng/ml and 1258.88 ± 1012, 80 ng/ml) didn’t differ in both groups, however, the frequency of elevated ECP levels was higher in the group of CMPA (63% and 30%, p <0.05). And the blood in the stool was detected more often(22.2% and 0%, p <0.05). The correlation between the levels of calprotectin and ECP (r = 0.55, p <0.05) and between the levels of FOG and ECP (r = 0.37, p<0.05) was found.
Conclusion: Clinical diagnosis of CMPA in infants should be supplemented with coprological tests of FOG, ECP and hidden blood in the stool for the well-timed diagnosis of CMPA gastrointestinal manifestations and secondary SLI.
Процитировать:
Novikova V.P., Bogdanova N.M., Prokopyeva N., Lapin S.V., Kuznetsova D.A., Vorontsov P. Secondary lactose intolerance and cow's milk protein allergy in infant. Archives of Disease in Childhood. 2019. 104(Suppl 3):A159.2-A160 DOI:10.1136/archdischild-2019-epa.367