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Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report

BACKGROUND: Hematochezia is a frequent symptom in early infancy. However, it occurs very rarely within the immediate neonatal period, and its occurrence before any oral intake is particularly rare. Because of the “congenital” presentation of hematochezia in our patient, we initially considered our c...

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Autores principales: Debuf, Marie-Julie, Claeys, Tania, Stalens, Jean-Philippe, Cornette, Luc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472870/
https://www.ncbi.nlm.nih.gov/pubmed/28619048
http://dx.doi.org/10.1186/s13256-017-1318-z
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author Debuf, Marie-Julie
Claeys, Tania
Stalens, Jean-Philippe
Cornette, Luc
author_facet Debuf, Marie-Julie
Claeys, Tania
Stalens, Jean-Philippe
Cornette, Luc
author_sort Debuf, Marie-Julie
collection PubMed
description BACKGROUND: Hematochezia is a frequent symptom in early infancy. However, it occurs very rarely within the immediate neonatal period, and its occurrence before any oral intake is particularly rare. Because of the “congenital” presentation of hematochezia in our patient, we initially considered our case to be a non-classical, potentially severe type of food protein-induced allergic proctocolitis. This diagnosis needs to be confirmed by an abnormal oral challenge test once the hematochezia has disappeared. If such a challenge cannot demonstrate an allergic origin, then the etiology of the hematochezia could be a neonatal transient eosinophilic colitis. Only two similar cases have been described so far. CASE PRESENTATION: We report the case of a black baby boy of African origin born at 36 weeks 5 days of gestational age who presented with massive hematochezia immediately after birth. A rectosigmoidoscopy revealed a severe inflammation associated with diffuse eosinophilic infiltration on biopsy. His clinical outcome was favorable after introduction of an amino acid formula diet. We initially considered our case to be a non-classical, potentially severe type of food protein-induced allergic proctocolitis but reintroduction of standard formula milk at the age of 3 months was successful. So, our patient is the first newborn in Europe who fits the diagnosis of “neonatal transient eosinophilic colitis.” CONCLUSIONS: We discuss the possible etiology of “congenital” eosinophilic inflammation of the distal colon and conclude that hematochezia in well-looking neonates, in the absence of negative challenge tests later on, is more likely to be a neonatal transient eosinophilic colitis than an allergic proctocolitis. This new entity could be more frequent than previously thought, changing our medical care strategies for this kind of neonatal symptom.
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spelling pubmed-54728702017-06-21 Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report Debuf, Marie-Julie Claeys, Tania Stalens, Jean-Philippe Cornette, Luc J Med Case Rep Case Report BACKGROUND: Hematochezia is a frequent symptom in early infancy. However, it occurs very rarely within the immediate neonatal period, and its occurrence before any oral intake is particularly rare. Because of the “congenital” presentation of hematochezia in our patient, we initially considered our case to be a non-classical, potentially severe type of food protein-induced allergic proctocolitis. This diagnosis needs to be confirmed by an abnormal oral challenge test once the hematochezia has disappeared. If such a challenge cannot demonstrate an allergic origin, then the etiology of the hematochezia could be a neonatal transient eosinophilic colitis. Only two similar cases have been described so far. CASE PRESENTATION: We report the case of a black baby boy of African origin born at 36 weeks 5 days of gestational age who presented with massive hematochezia immediately after birth. A rectosigmoidoscopy revealed a severe inflammation associated with diffuse eosinophilic infiltration on biopsy. His clinical outcome was favorable after introduction of an amino acid formula diet. We initially considered our case to be a non-classical, potentially severe type of food protein-induced allergic proctocolitis but reintroduction of standard formula milk at the age of 3 months was successful. So, our patient is the first newborn in Europe who fits the diagnosis of “neonatal transient eosinophilic colitis.” CONCLUSIONS: We discuss the possible etiology of “congenital” eosinophilic inflammation of the distal colon and conclude that hematochezia in well-looking neonates, in the absence of negative challenge tests later on, is more likely to be a neonatal transient eosinophilic colitis than an allergic proctocolitis. This new entity could be more frequent than previously thought, changing our medical care strategies for this kind of neonatal symptom. BioMed Central 2017-06-16 /pmc/articles/PMC5472870/ /pubmed/28619048 http://dx.doi.org/10.1186/s13256-017-1318-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Debuf, Marie-Julie
Claeys, Tania
Stalens, Jean-Philippe
Cornette, Luc
Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
title Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
title_full Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
title_fullStr Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
title_full_unstemmed Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
title_short Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
title_sort hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472870/
https://www.ncbi.nlm.nih.gov/pubmed/28619048
http://dx.doi.org/10.1186/s13256-017-1318-z
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