Gastrointestinal milk intolerance of infancy
S. Berezin, S. M. Schwarz, M. Glassman, M. Davidian and L. J. Newman
Department of Pediatrics, New York Medical College, Valhalla 10595.
During a period of 30 months, cow's milk- or soy protein-induced colitis
was diagnosed in 22 infants. All patients presented with hematochezia. Only
three patients had substantial diarrhea. Colonoscopic evaluations
demonstrated a characteristic mucosal appearance, manifested by aphthoid
ulcerations with intervening, normal-appearing mucosa. Histologic findings
included surface ulcerations and associated inflammation of the lamina
propria and submucosa, marked by substantial eosinophilic infiltration.
Both clinical symptoms and colonoscopic abnormalities rapidly resolved in
all patients after the elimination of cow's milk and/or soy protein from
the diet. These data indicate that hematochezia may be the predominant
symptom of cow's milk protein and soy protein intolerance in many affected
infants, and that colonoscopy is the most effective means of establishing a
definitive diagnosis in this patient population.
