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　　背景：牛奶蛋白过敏(CMPA)在儿童中的临床表现各不相同。本回顾性研究旨在调查CMPA在儿童缺铁性贫血(IDA)评估中的患病率和临床表现。方法：对2005-2015年在台湾国立成功大学医院诊断为IDA(血清铁蛋白<12 ng/mL)的4岁以下患者进行回顾性分析。分析他们的临床表现、实验室数据、内镜检查结果和预后。结果：51例IDA患者中有7例(13.7%)有CMPA。脸色苍白(100%)、发育不良(43%)和全身水肿(43%)是常见的特征。6人(86%)有低白蛋白血症，4人(57%)大便隐血阳性。在接受皮肤点刺试验的5例患者中，4例(80%)有阳性结果。大多数结肠镜检查显示为糜烂性、出血性结肠炎和淋巴样增生，但没有一例活检显示固有层嗜酸性粒细胞增多。所有患者在补充牛奶蛋白和铁7个月后恢复正常。结论：对于未确诊的IDA幼儿，应考虑CMPA。去除牛奶中的过敏蛋白质和补充铁对恢复健康有帮助。


延伸阅读
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
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。