[Cow's milk allergy in infantile colic]

Introduction and Objective: cow's milk allergy has been considered as a cause of infantile colic. Many physicians change the diet of these infants to a cow's milk free diet. In this study, we evaluated the role of cow's milk allergy in infantile colic in breast fed infants

Materials and Methods: this single blind clinical trial was done in infants between three weeks and three months old with infantile colic who were referred to a subspecialty clinic in Shiraz-Iran from September 2003 to February 2004. Only exclusively breast fed infants were selected. For other infants who were formula fed, only a questionnaire was filled out, stool exam was performed and they were then excluded from the study. Skin prick tests with cow's milk and stool exams [for occult blood] were performed for these infants, and the correct technique of breast feeding was taught to their mothers. Then, the infants were divided to case and control groups randomly. In the case group, the mothers were advised not to consume cow's milk and other dairy products for two weeks. But in the control group, no change in the diet of the mothers was recommended. Furthermore, 50 healthy infants without symptoms of colic were included in the study as the second control group. Their mothers were asked about the type of feeding and stool exams were done for them. Finally, the data were analyzed using chi-square test

Results: from all 270 examined infants, colic was confirmed in 169 cases. Among them, 153 infants were breast fed exclusively. 114 cases in this group allowed the skin prick test to be done. The test was positive in only 3 infants [2.6%]. From these 114 infants, only 77 infants completed the study. 35 infants were in the case group and 42 infants were in the control group. Infants with colic whose mothers did not take dairy products, did not improve significantly in comparison with the control group. Prevalence of formula feeding was significantly higher in colicky infants in comparison with non-colicky infants [24% and 2% respectively]. Prevalence of occult blood in the stools of colicky infants was significantly higher in colicky infants than non-colicky infants [24% and zero respectively]

Conclusion: due to the unresponsiveness of infants to the elimination of cow's milk, it can be concluded that cow's milk allergy is not a common cause of infantile colic. Therefore, it is not advised to eliminate the dairy products from the diet of nursing mothers. Also, it is not necessary to perform skin prick tests as a routine test in these infants. The high prevalence of occult blood in the stools of infants suffering from colic is a new finding. Evaluation of its cause will be helpful in determining the etiology of infantile colic

[Long-term effect of adenotonsillectomy at childhood on height and weight of boys in Shiraz]

Introduction: this study was performed to assess the long-term effect of adenotonsillectomy on growth parameters among adolescent boys in Shiraz

Material and Methods: 141 adolescent boys who had positive history for adenotonsillectomy at childhood period were randomly selected [group A]. Also a control group [B] was selected among boys of the same age range

Results: the mean values of weight and height did not reveal significant difference between two groups. Also weight and height percentile curves were almost identical

Conclusion: adenotonsillectomy in childhood might normalize future growth. These children will have almost the same weight and height values during adolescence, compared with others

Role of IgE low-affinity receptor [CD23] in pathogenesis of nasal polyp

Nasal polyps, a common clinical problem, are characterized by eosinophilic and mast cell inflammation. The role of allergy and IgE in pathogenesis of nasal polyps is still unclear. IgE receptors are important components of the immunological pathway in allergic and inflammatory diseases. To determine if the low affinity IgE receptor [CD23] is presented on nasal polyp tissues as a marker of local allergy or inflammation. Twenty patients who had undergone polypectomy enrolled into the study. Polyp tissues were stained by hematoxylineosin and acid-fast methods for histopathologic study. Immunohistochemical staining was performed with monoclonal antibody to leukocyte surface CD23. Polyp tissue fluid was extracted by slicing and centrifuging. Total serum IgE and tissue fluid was measured by ELISA. Thirteen of 20 polyp tissues were positive for CD23. Moderate to large number of eosinophils were observed in 5 patients. Serum IgE level was elevated [>70 IU /ml] in 13 patients and polyp IgE level was elevated in 8 patients. No significant correlation was found between CD23, serum and polyp tissue IgE, and eosinophil infiltration. CD23 may act as non-IgE dependent inflammatory marker in the pathogenesis of nasal polyps