Clinical Feature Of Food Protein-induced Enteropathy (14 Cases Report)

Objective:To investigate the clinical manifestations,diagnosis and treatment of food protein-induced enteropathy(FPE)in children.Methods:Clinical data of 14 patients with FPE in department of Gastroenterology,Children’s Hospital of Chongqing Medical University from April 2012 to March 2016 were analyzed and pertinent literatures were reviewed.Results:The median age of 14 patient with FPE(10 male and 4 female)was 1.5 months. Cow’s milk(6/14,42.9%) was most common allergen,followed by were peanut(3/14,21.4%),cow’s milk or egg(3/14,21.4%),shrimp(1/14,7.1%)and soybean(1/14,7.1%). The main clinical manifestations were chronic diarrhea(14/14,100%), followed by were malnutrition(10/14,71.4%),anemia(6/14,42.9%), hypoalbuminemia(4/14,28.6%),vomiting(4/14,28.3%),bloody stool(3/14,21.4%)and abdominal distension(3/14,21.4%). Endoscopic and histological findings include mucosal inflammation and distortion of the villous architecture with a ‘patchy’ distribution.Treating by food eliminate, probiotics,zinc and glutamin,most patients have desensitized(8/12,66.7%), some in the desensitization process(2/12,16.7%) and two cases are not desensitized(2/12,16.7%).Conclusion:FPE should be considered when children with unreasonable chronic diarrhea and malnutrition.Cow’s milk was the most common allergen. The diagnosis of FPE relies mainly on the food avoid and challenge test Detailed history combined with small intestinal mucosal histology examination has great diagnostic value. Food eliminate is the mainstay of FPE management,most patients can desensitization about 3 years old.