Document Detail


Food hypersensitivity as a cause of rectal bleeding in adults.
MedLine Citation:
PMID:  19124116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Rectal bleeding and lymphonodular hyperplasia (LNH) in children can be caused by food hypersensitivity (FH). Our aim was to verify whether similar clinical and endoscopy presentations in adults can be due to FH. METHODS: Consecutive adult patients with rectal bleeding were enrolled. All underwent routine assays, colonoscopy, and histology study. RESULTS: Ten of 64 (15%) patients showed LNH as the unique sign at colonoscopy. An oligoantigenic diet resolved the rectal bleeding in 9 patients, and the reintroduction of several foods caused symptom reappearance. Double-blind placebo-controlled challenges with cow's milk and wheat protein confirmed the FH; symptoms reappeared 1-96 hours after the challenge. None of the patients were positive for IgE-mediated assays. In patients with LNH and FH, histology of the ileum and colon mucosa showed a higher number of lymphoid follicles and intraepithelial and lamina propria eosinophils compared with the other patients with rectal bleeding. CONCLUSIONS: Recurrent rectal bleeding can be caused by FH in adult patients. Endoscopic evidence of LNH characterizes these cases.
Authors:
Antonio Carroccio; Giuseppe Iacono; Lidia Di Prima; Alberto Ravelli; Giuseppe Pirrone; Angelo B Cefalù; Ada M Florena; Giovan Battista Rini; Gaetana Di Fede
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-08-05
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  7     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-06     Completed Date:  2009-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  120-2     Citation Subset:  IM    
Affiliation:
Internal Medicine, Ospedali Civili Riuniti di Sciacca, University of Palermo, Palermo, Italy. acarroccio@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Child
Colonoscopy
Double-Blind Method
Food Hypersensitivity / complications*
Hemorrhage / etiology*
Histocytochemistry
Humans
Hyperplasia
Immunoglobulin E / analysis
Intestinal Mucosa / immunology,  pathology
Lymph Nodes / pathology
Middle Aged
Milk Hypersensitivity / diagnosis
Placebos / administration & dosage
Rectal Diseases / etiology*
Recurrence
Wheat Hypersensitivity / diagnosis
Chemical
Reg. No./Substance:
0/Placebos; 37341-29-0/Immunoglobulin E

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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