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Síntomas digestivos y respuesta clínica en lactantes con alergia a la proteína de leche de vaca / Gastrointestinal symptoms and clinical response of infants with cow's milk protein allergy
Vera CH., José Fernando; Ramírez V., Andrea.
  • Vera CH., José Fernando; Hospital Universitario Fundación Santa Fe. Sección de Gastroenterología, Hepatología y Nutrición Pediátrica. Bogotá. CO
  • Ramírez V., Andrea; Hospital Universitario Fundación Santa Fe. Grupo de Investigación PEDIAFE, Centro de Investigación en Salud. Bogotá. CO
Rev. chil. pediatr ; 84(6): 641-649, dic. 2013. tab
Article in Spanish | LILACS | ID: lil-703287
RESUMEN

Introducción:

La calidad de vida y estado nutricional del lactante con alergia a la proteína de leche de vaca (APLV) pueden comprometerse sin un adecuado diagnóstico y tratamiento oportuno.

Objetivo:

Describir síntomas digestivos, antecedentes familiares y perinatales, estado nutricional y respuesta de lactantes < 12 meses con APLV entre junio de 2007 y agosto de 2011. Pacientes y

Método:

Estudio retrospectivo, descriptivo en lactantes < 12 meses de edad que consultan por sospecha de APVL. Se investigaron antecedentes familiares, perinatales y características clínicas. Se excluyó a los casos sin prueba de alimentación o provocación abierta, o cuyo motivo de consulta correspondió a otra patología. Se usó el programa STATA especial edición 11,1 para el análisis estadístico. Se consideró estadístico y significativo un p < 0,05.

Resultados:

Se diagnosticaron 40 lactantes (57,5 por ciento varones), edad 3,0 +/- 0,4 meses, clínica de 2 +/- 0,3 meses de vómito/regurgitación 20, diarrea sanguinolenta 8, falla en el crecimiento 4, cólico/irritabilidad 4, deposición normal con sangre en 3. Los antecedentes familiares y perinatales fueron ingesta de biberón en la 1ª semana de vida 35, madre > 30 años 31 casos, atopia en 2 familiares (padres/hermanos) 28, parto por cesárea 27. Al seguimiento de 14 +/- 1,4 meses, 19 respondieron a fórmula ampliamente hidrolizada +/- seno; 19 a fórmula de aminoácidos +/- seno y un paciente lactancia exclusiva. El Z-score de P/E-1,05 +/- 1,28; T/E -0,96 +/- 1,60; IMC -0,61 +/- 1,03 en primera consulta, mejoró al año P/E -0,15 +/- 1,24; T/E -0,29 +/- 1,14 e IMC -0,04 +/- 1,20 (p < 0,05), independiente de la fórmula (p = NS). Veintitres toleraron leche entera al año.

Conclusiones:

En este estudio los síntomas predominantes al inicio de los pacientes con APLV fueron vómitos, regurgitación y diarrea sanguinolenta. Entre los antecedentes destacan la exposición temprana a PLV, atopia familiar y parto por cesárea...
ABSTRACT

Introduction:

Quality of life and nutritional status of infants with cow's milk protein allergy (CMA) can be compromised without a proper diagnosis and treatment.

Objective:

To describe digestive symptoms, family and perinatal history and nutritional status of < 12 month infants with CMA between June 2007 and August 2011. Patients and

Method:

A retrospective and descriptive study in < 12 month old infants suspecting CMA was performed. Family history, perinatal and clinical characteristics were studied. Cases without food test or open challenge test, or whose reason for consultation corresponded to other pathology were excluded. The program STATA 11.1 was used for statistical analysis and p < 0.05 was considered statistically significant.

Results:

40 infants (57.5 percent boys), age 3 +/- 0.4 months and history of 2 +/- 0.3 months presenting the following 20 of them (50 percent, vomiting/regurgitation; 8 (20 percent, bloody diarrhea; 4 (10 percent) failure to thrive; 4 (10 percent), colic/irritability and bloody normal deposition was present in 3 individuals (7.5 percent). Family and perinatal history 35 (87.5 percent were bottle-fed during the first week of life; 31 (77.5 percent) had > 30 year old mothers; 28 (70 percent described 2 family members (parents/siblings) with atopy; 27 (67.5 percent were delivered via cesarean. At the 14 +/- 1.4-month follow-up, 19 (47.5 percent responded to extensively hydrolyzed formula +/- breastfeeding; 19 to amino acid formula +/- breastfeeding and one patient to breastfeeding exclusively. The Z -score for P/E was -1.05 +/- 1.28; T/E -0.96 +/- 1.60; BMI -0.61 +/- 1.03 in the first consultation; after a year, scores improved P/E -0.15 +/- 1.24; T/E -0.29 +/- 1.14 and BMI -0.04 +/- 1.20 (p < 0.05), independent from formula (p = NS). 23 (74 percent) tolerated whole milk when reached a year old.

Conclusions:

In this study, the predominant early symptoms were...
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Milk Hypersensitivity / Digestive System Diseases / Milk Proteins Type of study: Diagnostic study / Etiology study / Observational study Limits: Animals / Female / Humans / Male Language: Spanish Journal: Rev. chil. pediatr Journal subject: Pediatrics Year: 2013 Type: Article Affiliation country: Colombia Institution/Affiliation country: Hospital Universitario Fundación Santa Fe/CO

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Full text: Available Index: LILACS (Americas) Main subject: Milk Hypersensitivity / Digestive System Diseases / Milk Proteins Type of study: Diagnostic study / Etiology study / Observational study Limits: Animals / Female / Humans / Male Language: Spanish Journal: Rev. chil. pediatr Journal subject: Pediatrics Year: 2013 Type: Article Affiliation country: Colombia Institution/Affiliation country: Hospital Universitario Fundación Santa Fe/CO