Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?

• Published in: Clinical and experimental pediatrics Vol. 56; no. 12; pp. 514 - 518
• Main Authors: Hwang, Jin-Bok, Hong, Jeana
• Format: Journal Article Book Review
• Language: English
• Published: Korea (South) Clinical and Experimental Pediatics / Korean Pediatric Society 01-12-2013; The Korean Pediatric Society; Korean Pediatric Society; 대한소아청소년과학회
• Subjects: Biopsy; Breastfeeding & lactation; Cytomegalovirus; Dairy industry; Diet; Dietary protein; Endoscopy; Food allergies; Food allergy; Food hypersensitivity; Herpes viruses; Hyperplasia; Infections; Inflammatory bowel disease; Laboratories; Milk; Neonates; Newborn babies; Proctocolitis; Proteins; Rectal bleeding; Review; Rotavirus; Viral infections; 소아과학; Dietary protein; Food allergy; Neonates; Rectal bleeding; Proctocolitis; Food hypersensitivity
• ISSN: 1738-1061; 2092-7258; 2713-4148
• DOI: 10.3345/kjp.2013.56.12.514

The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for diagnosing suspected FPIPC in neonates is as follows. During the early stage, the etiology of small and fresh rectal bleeding in an otherwise healthy newborn need not be studied through extensive investigations. In patients showing continued bleeding even after 4 days, sigmoidoscopy and rectal mucosal biopsy may be performed. Even if mucosal histological findings indicate a diagnosis of FPIPC, further oral food elimination and challenge tests must be performed sequentially to confirm FPIPC. Food elimination and challenge tests should be included in the diagnostic criteria of FPIPC.