CAJ | 학술논문

目的：探讨牛奶蛋白过敏及牛奶蛋白过敏导致的食物诱导性小肠结肠炎综合征的临床诊断和治疗。方法回顾性分析1例牛奶蛋白过敏导致婴儿食物诱导性小肠结肠炎综合征的临床资料。结果出生67d女性患儿，出生起即混合喂养，出生后2周起反复腹泻、腹胀、呕吐、黏液血便、喂养困难、贫血和生长发育迟缓。实验室检查见贫血、白细胞总数和C反应蛋白升高、嗜酸性粒细胞比例增高，牛奶特异性IgE阴性。4次住院及入院时均诊断为“坏死性小肠结肠炎”。经回避牛奶蛋白4周后，症状消失，牛奶蛋白激发试验阳性，符合牛奶蛋白过敏以及牛奶蛋白过敏导致婴儿食物诱导性小肠结肠炎特征。结论牛奶蛋白过敏及牛奶蛋白过敏导致婴儿食物诱导性小肠结肠炎的临床表现非特异性，症状体征多样，临床需注意辨别。
목적：탐토우내단백과민급우내단백과민도치적식물유도성소장결장염종합정적림상진단화치료。방법회고성분석1례우내단백과민도치영인식물유도성소장결장염종합정적림상자료。결과출생67d녀성환인，출생기즉혼합위양，출생후2주기반복복사、복창、구토、점액혈편、위양곤난、빈혈화생장발육지완。실험실검사견빈혈、백세포총수화C반응단백승고、기산성립세포비례증고，우내특이성IgE음성。4차주원급입원시균진단위“배사성소장결장염”。경회피우내단백4주후，증상소실，우내단백격발시험양성，부합우내단백과민이급우내단백과민도치영인식물유도성소장결장염특정。결론우내단백과민급우내단백과민도치영인식물유도성소장결장염적림상표현비특이성，증상체정다양，림상수주의변별。
To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding dififculty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-speciifc IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of“necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein re-challenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-speciifc and variable clinical symptoms and signs, and should be considered in the differential diagnosis.