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KMID : 0191120080230020251
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Journal of Korean Medical Science
2008 Volume.23 No. 2 p.251 ~ p.255
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The Significance of Gastric Juice Analysis for a Positive Challenge by a Standard Oral Challenge Test in Typical Cow’s Milk Protein-Induced Enterocolitis
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Hwang Jin-Bok
Kam Sin
Choi Won-Joung
Kang Yu-Na
Kim Sang-Pyo
Suh Seong-Il
Song Jeong-Yoon
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Abstract
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This study was performed to investigate the significance of gastric juice analysis (GJA) as a diagnostic criterion of a positive challenge in a standard oral cow’s milk challenge (OCC) to confirm typical cow’s milk protein-induced enterocolitis (CMPIE). Data from 16 CMPIE patients (aged 14 to 44 days) were analyzed. A standard OCC was openly executed using 0.15 g/kg of protein. Three symptoms (vomiting, lethargy, and bloody or pus-like stool), and four laboratory findings (GJA [3 hr], changes in peripheral blood absolute neutrophil count [ANC] [6 hr], C-reactive protein [6 hr], and stool smear test for occult blood or leukocytes) were observed after OCC. Before OCC, baseline studies were conducted; a stool smear test, blood sampling, and GJA. Positive OCC results were; vomiting (87.5%) (observed 1-3 hr after OCC), lethargy (62.5%) (1-3 hr), bloody or pus-like stool (43.8%) (6-10 hr), abnormal GJA (93.8%), an ANC rise >3,500 cells/microliter (93.8%), and an abnormal stool smear test (75.0%). A single GJA test after a standard OCC is a sensitive diagnostic criterion of a positive challenge, and may provide an early confirmatory diagnosis of CMPIE. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in CMPIE.
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KEYWORD
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Food Hypersensitivity, Cow’s Milk Protein-Induced Enterocolitis, Oral Challenge, Diagnostic Criteria, Gastric Juice Analysis
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