Allergic colitis historical perspective: Difference between revisions
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==Overview== | ==Overview== | ||
==Historical Perspective== | ==Historical Perspective== | ||
The first description of eosinophilic colitis was made by | |||
Kaijser in 1937.43 Allergic proctocolitis was described by | |||
Rubin in 1940 and subsequently by Grybosky in the 1960s. | |||
They manifest as inflammatory changes of the colon and rectum, | |||
secondary to immune reactions triggered by ingestion | |||
of food proteins | |||
Gryboski [1] published the first case series of food protein enterocolitis to cow milk formula in neonates. Unlike cow milk proctocolitis, infants were unwell with prolonged diarrhea and vomiting after drinking cow milk formula for days to weeks. Frank or occult blood in the stools and anemia were noted in all cases, and half of the infants were failing to thrive on presentation [2,3]. Rectal biopsies showed either a slight infiltrate of lymphocytes/plasma cells or profuse polymorphonuclear cell infiltration, crypt abscess formation and mucosal injury [1].Almost 10 years later, Powell [2,3] described the same condition following cow milk formula introduction in a smaller cohort, most of whom were neonates. Additionally, she noted some cases had abdominal distension, hypothermia, peripheral blood neutrophilia, and stools frequently contained a mixture of inflammatory cells, including lymphocytes, neutrophils and eosinophils. Both authors reported if reexposure to cow milk formula occurred after a brief period of abstinence, some infants presented acutely with profuse vomiting and diarrhea, cardiovascular collapse and neutrophilia usually 2 h after ingestion [1,3]. Powell [2,3] further recognized many infants with chronic cow milk enterocolitis also had an acute or chronic enterocolitis reaction once exposed to soy formula.McDonald et al.[4] first coined the term food protein-induced enterocolitis (FPIE), recognizing cow milk/soy protein likely triggered the reaction and that chronic exposure to the food protein was required to cause intestinal injury. Two years later the same authors reported three cases of acute egg enterocolitis in infants with cow milk/soy enterocolitis, but with no prior history of egg ingestion [5]. Some 20 years earlier, Ikola [6] had published a case of an infant with acute rice and wheat enterocolitis, following initial introduction of these foods. These early studies highlighted that acute reactions could occur without previous chronic exposure or enterocolitis and other food proteins apart from cow milk/soy could trigger acute reactions. | Gryboski [1] published the first case series of food protein enterocolitis to cow milk formula in neonates. Unlike cow milk proctocolitis, infants were unwell with prolonged diarrhea and vomiting after drinking cow milk formula for days to weeks. Frank or occult blood in the stools and anemia were noted in all cases, and half of the infants were failing to thrive on presentation [2,3]. Rectal biopsies showed either a slight infiltrate of lymphocytes/plasma cells or profuse polymorphonuclear cell infiltration, crypt abscess formation and mucosal injury [1].Almost 10 years later, Powell [2,3] described the same condition following cow milk formula introduction in a smaller cohort, most of whom were neonates. Additionally, she noted some cases had abdominal distension, hypothermia, peripheral blood neutrophilia, and stools frequently contained a mixture of inflammatory cells, including lymphocytes, neutrophils and eosinophils. Both authors reported if reexposure to cow milk formula occurred after a brief period of abstinence, some infants presented acutely with profuse vomiting and diarrhea, cardiovascular collapse and neutrophilia usually 2 h after ingestion [1,3]. Powell [2,3] further recognized many infants with chronic cow milk enterocolitis also had an acute or chronic enterocolitis reaction once exposed to soy formula.McDonald et al.[4] first coined the term food protein-induced enterocolitis (FPIE), recognizing cow milk/soy protein likely triggered the reaction and that chronic exposure to the food protein was required to cause intestinal injury. Two years later the same authors reported three cases of acute egg enterocolitis in infants with cow milk/soy enterocolitis, but with no prior history of egg ingestion [5]. Some 20 years earlier, Ikola [6] had published a case of an infant with acute rice and wheat enterocolitis, following initial introduction of these foods. These early studies highlighted that acute reactions could occur without previous chronic exposure or enterocolitis and other food proteins apart from cow milk/soy could trigger acute reactions. | ||
Box 1 | Box 1 | ||
Revision as of 18:53, 26 September 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]
Overview
Historical Perspective
The first description of eosinophilic colitis was made by Kaijser in 1937.43 Allergic proctocolitis was described by Rubin in 1940 and subsequently by Grybosky in the 1960s. They manifest as inflammatory changes of the colon and rectum, secondary to immune reactions triggered by ingestion of food proteins
Gryboski [1] published the first case series of food protein enterocolitis to cow milk formula in neonates. Unlike cow milk proctocolitis, infants were unwell with prolonged diarrhea and vomiting after drinking cow milk formula for days to weeks. Frank or occult blood in the stools and anemia were noted in all cases, and half of the infants were failing to thrive on presentation [2,3]. Rectal biopsies showed either a slight infiltrate of lymphocytes/plasma cells or profuse polymorphonuclear cell infiltration, crypt abscess formation and mucosal injury [1].Almost 10 years later, Powell [2,3] described the same condition following cow milk formula introduction in a smaller cohort, most of whom were neonates. Additionally, she noted some cases had abdominal distension, hypothermia, peripheral blood neutrophilia, and stools frequently contained a mixture of inflammatory cells, including lymphocytes, neutrophils and eosinophils. Both authors reported if reexposure to cow milk formula occurred after a brief period of abstinence, some infants presented acutely with profuse vomiting and diarrhea, cardiovascular collapse and neutrophilia usually 2 h after ingestion [1,3]. Powell [2,3] further recognized many infants with chronic cow milk enterocolitis also had an acute or chronic enterocolitis reaction once exposed to soy formula.McDonald et al.[4] first coined the term food protein-induced enterocolitis (FPIE), recognizing cow milk/soy protein likely triggered the reaction and that chronic exposure to the food protein was required to cause intestinal injury. Two years later the same authors reported three cases of acute egg enterocolitis in infants with cow milk/soy enterocolitis, but with no prior history of egg ingestion [5]. Some 20 years earlier, Ikola [6] had published a case of an infant with acute rice and wheat enterocolitis, following initial introduction of these foods. These early studies highlighted that acute reactions could occur without previous chronic exposure or enterocolitis and other food proteins apart from cow milk/soy could trigger acute reactions. Box 1 Box 1 Image Tools Sicherer et al.[7] suggested the disorder be called a syndrome, recognizing the disease was characterized by a constellation of shared clinical and laboratory features. Thus, FPIE became FPIES. Two distinct phenotypes of the disorder are recognized, acute and chronic FPIES, with the latter representative of the disorder first reported by Gryboski [1]. The differences between these two clinical phenotypes have been reviewed elsewhere [8]. To date, only cow milk/soy have been documented to cause chronic FPIES [1–3,9,10], whereas a range of foods has been reported to cause acute FPIES.