Failure to thrive and Gastrointestinal Food Hypersensitivity
Dr Widodo Judarwanto SpA
CHILDREN ALLERGY CLINIC
PICKY EATERS CLINIC (KLINIK KESULITAN MAKAN)
Jl Taman Bendungan Asahan 5 Bendungan Hilir Jakarta Pusat
telp : (021) 70081995 – 70081995
email : wido25@hotmail.com , http://alergianak.blogspot.com
Gastrointestinal Food hypersensitivity has been held accountable for a multi-tude of gastro-intestinal symptoms in infants. Vomiting,colic, diarrhoea, melaena, and constipation have all been reported in various patients (Collins-Williams, 1956). In most of these cases, however, the infants do well in that they gain weight in spite of their symptoms.
The following case of gastro-intestinal allergy to cow's milk is thus particularly interesting in that the symptoms were so severe that the presenting picture was one of marasmus.
The diagnosis of milk allergy is substantiated in this case by the appearance of vomiting with the use of cow's milk, the inability to demonstrate other causes for the vomiting, the disappearance of the symptoms with the elimination of the allergen, and the reappearance of the symptoms on two separate occasions following the reintroduction of cow's milk. These criteria are, after all, the basic ones for the establishment of the diagnosis. A family history of allergy, present in this case, is a useful but not essential adjunct in making the diagnosis. Eosinophils in the stools are a helpful indication of gastro-intestinal allergy as described by Rosenblum and Rosenblum (1952). Unfortunately this test was not carried out in this case, nor was it really needed to establish the diagnosis.
The reported frequency of allergy to cow's milk varies widely, owing, of course, to the different criteria for diag-nosis. Clein (1951) states that roughly 7% of children have some degree of allergy to cow's milk. Collins-Williams (1956) places the total incidence at only 0.3%. In either case, however, various gastro-intestinal symptoms are im-portant, and are frequently the
Marasmus Resulting from Gastro-intestinal Allergy Allergy to cow's milk has been held accountable for a multi-tude of gastro-intestinal symptoms in infants. Vomiting, colic, diarrhoea, melaena, and constipation have all been reported in various patients (Collins-Williams, 1956). The infants do well in that they gain weight in spite of their symptoms (Nelson, 1954). The following case of gastro-intestinal allergy to cow's milk is thus particularly interesting in that the symptoms were so severe that the presenting picture was one of marasmus.
