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J Health Popul Nutr ; 2005 Dec; 23(4): 331-8
Article in English | IMSEAR | ID: sea-698

ABSTRACT

Nineteen American infants aged less than three months developed persistent diarrhoea, acidosis, hypoalbuminaemia, and malnutrition, without evidence of enteric pathogens. Symptoms began 11-59 days before admission to the University of North Carolina Children's Hospital, and infants were fed semielemental formula. Despite further treatment with amino acid-based formula by continuous nasogastric infusion, diarrhoea persisted. Endoscopic biopsies showed inflammation in the stomach, duodenum, and/or colon. A trial of intravenous corticosteroids was initiated in 14 infants. Corticosteroids were associated with rapid resolution of diarrhoea (duration after corticosteroids = 3.8 +/- 1.7 days [mean +/- SD]). In contrast, five infants with identical history were not treated with corticosteroids. In three infants, diarrhoea lasted for 92-147 days versus 31 +/- 3 total days in the treated group. In the other two infants, diarrhoea worsened after discharge, but were treated later with corticosteroids, with rapid resolution. Corticosteroids were uneventfully weaned over a four-month period. The results suggest that a trial of corticosteroids in infants with unresponsive persistent diarrhoea of unknown origin is beneficial and deserves prospective evaluation.


Subject(s)
Acidosis/complications , Adrenal Cortex Hormones/administration & dosage , Amino Acids/administration & dosage , Biopsy/methods , Chronic Disease , Diarrhea, Infantile/complications , Endoscopy/methods , Female , Humans , Hypoalbuminemia/complications , Infant , Infant Nutrition Disorders/complications , Infant, Newborn , Infusions, Intravenous/methods , Male , North Carolina , Retrospective Studies , Time Factors , Treatment Outcome
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