背景：牛奶蛋白過敏(CMPA)在兒童中的臨床表現(xiàn)各不相同。本回顧性研究旨在調(diào)查CMPA在兒童缺鐵性貧血(IDA)評估中的患病率和臨床表現(xiàn)。方法：對2005-2015年在臺灣國立成功大學醫(yī)院診斷為IDA(血清鐵蛋白<12 ng/mL)的4歲以下患者進行回顧性分析。分析他們的臨床表現(xiàn)、實驗室數(shù)據(jù)、內(nèi)鏡檢查結(jié)果和預后。結(jié)果：51例IDA患者中有7例(13.7%)有CMPA。臉色蒼白(100%)、發(fā)育不良(43%)和全身水腫(43%)是常見的特征。6人(86%)有低白蛋白血癥，4人(57%)大便隱血陽性。在接受皮膚點刺試驗的5例患者中，4例(80%)有陽性結(jié)果。大多數(shù)結(jié)腸鏡檢查顯示為糜爛性、出血性結(jié)腸炎和淋巴樣增生，但沒有一例活檢顯示固有層嗜酸性粒細胞增多。所有患者在補充牛奶蛋白和鐵7個月后恢復正常。結(jié)論：對于未確診的IDA幼兒，應考慮CMPA。去除牛奶中的過敏蛋白質(zhì)和補充鐵對恢復健康有幫助。


延伸閱讀
The prevalence and characteristics of cow's milk protein allergy in infants and young children with iron deficiency anemia
https://doi.org/10.1016/j.pedneo.2017.01.004　　IF:1.49
Background
The clinical presentation of cow's milk protein allergy (CMPA) in children varies. This retrospective study aimed to investigate the prevalence and clinical manifestations of CMPA in young children who visited for evaluation of iron deficiency anemia (IDA).
Methods
Patients aged <4 years who were diagnosed as having IDA (serum ferritin<12 ng/mL) at the National Cheng Kung University Hospital, Taiwan in the period 2005–2015 were reviewed. Their clinical presentations, laboratory data, endoscopyfindings, and prognosis were analyzed.
Results 
Seven of 51 IDA patients (13.7%) had CMPA. The pallor (100%), failure to thrive(43%), and general edema (43%) were the common features. Six (86%) had hypoalbuminemia and four (57%) had positive occult blood in the stool. Of the five patients who underwent skin prick test, four (80%) had positive results. Most of the colonoscopies revealed erosive and hemorrhagic colitis and lymphoid hyperplasia, but none of the biopsies demonstrated eosinophilia in the lamina propria. All of the patients recovered from their IDA within seven months of cow's milk protein elimination and iron supplementation.
Conclusion
CMPA should be considered in young children with undetermined IDA. Cow's milk protein elimination and iron supplementation help in the recovery.
Author:Fu-PingLaiYao-JongYang
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預防的共享平臺。