The diagnosis and outcomes of persistent diarrhea in infants aged 0-24 months - A Turkish cohort study
The diagnosis and outcomes of persistent diarrhea in infants aged 0-24 months - A Turkish cohort study
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DOI：
10.4318/tjg.2011.0211
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发表时间：
2011-06-01
影响因子：
1.2
通讯作者：
Ensari, Arzu
中科院分区：
文献类型：
--
作者：
Egritas, Odul;Sari, Sinan;Ensari, Arzu
背景/目的：婴儿持续性腹泻系列在文献中没有很好的记录。评估文献，本研究的目的是记录本中心随访的持续性腹泻病例，并通过调查方法为儿科医生提供实用的诊断算法。方法：以腹泻持续14 d以上为持续性腹泻。本文对41例0 ~ 24月龄持续性腹泻进行了调查。对这些病例进行粪便粘液和/或白细胞的评估，并将其分为结肠炎和肠病两大类。对于持续性结肠炎组的鉴别诊断，进行了粪便培养、饮食限制、全血细胞计数、急性期反应物、病理试验、家族性地中海热和白塞病基因分析、结肠镜检查和活检。在持续性肠病组，通过以下检查进行鉴别诊断：血清和粪便电解质、动脉血气、血清白蛋白、总蛋白、脂质谱、粪便α -1抗胰蛋白酶水平、粪便pH值、粪便脂肪和还原物质的存在、内窥镜检查和活检。结果：27例持续性肠病包括乳糜泻7例，肠淋巴管扩张5例，微绒毛包涵病2例，高蛋白血症2例，牛奶过敏11例。婴儿结肠炎组13例，白塞氏病1例，结肠炎溃疡1例，牛奶过敏11例。2例表现为胰腺功能不全，诊断为囊性纤维化。1例诊断为囊性纤维化合并牛奶过敏。结论：回顾文献，这些病例代表了持续腹泻的最大的非感染性婴儿群体。建立了一种实用的持续性腹泻诊断算法。
Background/aims: Infantile persistent diarrhea series are not well documented in the literature. Evaluating the literature, the aim of this study was to document persistent diarrhea cases followed in our center and to constitute a practical diagnostic algorithm for the pediatrician by means of surveying methods. Methods: Diarrheas lasting more than 14 days were accepted as persistent diarrhea. Forty-one persistent diarrhea cases aged 0-24 months were investigated in this study. The cases were evaluated for the presence of mucus and / or leukocytes in stool and were thus divided into two major groups as colitis or enteropathies. For the differential diagnosis of the persistent colitis group, stool cultures, dietary restrictions, complete blood count, acute phase reactants, pathergy test, gene analysis for familial Mediterranean fever and Behcet's disease, colonoscopy, and biopsies were performed. In the persistent enteropathy group, differential diagnosis was made with the following tests: serum and stool electrolytes, arterial blood gases, serum albumin, total protein, lipid profile, stool alpha-1 antitrypsin level, stool pH, presence of stool fat and reducing substance, endoscopy, and biopsies. Results: The 27 persistent enteropathy cases included 7 celiac disease, 5 intestinal lymphangiectasia, 2 microvillus inclusion disease, 2 abetalipoproteinemia, and 11 cow's milk allergy. The 13 cases of the infantile colitis group included 1 Behcet's disease, 1 colitis ulcerosa and 11 cow's milk allergy. Two cases presenting as pancreatic insufficiency were diagnosed as cystic fibrosis. One case was diagnosed as cystic fibrosis plus cow's milk allergy. Conclusions: Reviewing the literature, these cases represent the largest non-infectious infantile group of persistent diarrheas. A practical diagnostic algorithm for persistent diarrheas has been constituted.