Colon
Noninfectious colitis
Allergic colitis
Author: Hanni Gulwani, M.B.B.S.
Last author update: 1 September 2014
Last staff update: 7 December 2020
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: allergic colitis
Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Gulwani H. Allergic colitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colonallergic.html. Accessed April 20th, 2024.
Definition / general
- Allergic proctocolitis: benign disorder of blood streaked stools in otherwise healthy-appearing infants
- Occurs in infants and children related to food, particularly cow's milk in infants and soy or eggs in older children
- Both IgE and non-IgE related mechanisms (Allergol Immunopathol (Madr) 2009;37:36)
- Some clinical cases of food allergy in young children are eventually diagnosed as inflammatory bowel disease (Med Wieku Rozwoj 2006;10:475)
- Italian study of allergic proctocolitis: atopy patch tests positive in 100% infants, multiple positivity in 50%; sensitization for breast milk in 100%, cow's milk in 50%; also soy (28%), egg (21%), rice (14%), wheat (7%) (BMC Gastroenterol 2011;11:82)
Clinical features
- Symptoms: rectal bleeding (although nonspecific, J Pediatr Gastroenterol Nutr 2005;41:16), variable diarrhea; may have peripheral eosinophilia
Case reports
- Premature infant with rectal bleeding after first formula feeding (Acta Paediatr 2005;94:1514)
Treatment
- Removal of cow's milk from infant or (if breast fed) mother’s diet
- Elemental diet based on amino acid formula typically resolves symptoms in 2-3 days, GI eosinophilic inflammation within 6 weeks (Pediatr Allergy Immunol 2007;18:360)
Clinical images
Images hosted on other servers:
Endoscopic findings
Microscopic (histologic) description
- Rectal biopsy shows mucosal edema, prominent eosinophils (>60 per 10 HPF) aggregating around lymphoid nodules, in crypt abscesses and around muscularis mucosa; may have mild focal active colitis (J Pediatr Gastroenterol Nutr 1994;19:22)
- May have granulomatous features (Histopathology 2009;55:758)
Microscopic (histologic) images
Images hosted on other servers:
Eosinophilic infiltration
Differential diagnosis
- Dientamoeba fragilis infestation (J Pediatr Gastroenterol Nutr 1998;26:16)
- Eosinophilic colitis: different clinical history (Adv Anat Pathol 2011;18:335)
