Медицинский совет (Jul 2020)
The use of amino acid-based mixtures in clinical practice in children with combined gastrointestinal and skin symptoms. The view of the gastroenterologist
Abstract
Cow’s milk protein is a major allergen in infants and children and can provoke both IgE-mediated (immediate onset) and non-IgEmediated (delayed onset) reactions. It is reported that 2–3% of children under 3 years old are allergic to cow’s milk proteins. Allergy is characterized by multiple clinical manifestations, including skin symptoms, a variety of gastrointestinal symptoms, among which the most common are spitting up, abdominal bloating, flatulence, changes in stool characteristics in the form of diarrhoea or constipation. Most children with allergy to cow’s milk protein have a positive effect with reduced allergy symptoms when using extensively hydrolyzed formula, but in some children (5–10%) allergic reactions may persist due to the presence of small peptide fragments in the formula.The article provides a clinical example of the use of an amino acid-based mixture in a child with allergies to cow’s milk protein, gastrointestinal and skin symptoms, and no effect on the mixture based on highly hydrolyzed protein. When applying of an amino acid-based mixture a mixture (Neocate) and subsequent observation of the child after 1, 2 and 4 weeks, were noted normalization of the stool, a decrease in gas formation, the disappearance of skin manifestations, a decrease in the level of eosinophilic neurotoxin in the stool and a decrease in the time of anxiety of the child while maintaining normal rates of physical development. During the evaluation of the general blood test parameters in dynamics a decrease of eosinophilic concentration was shown from 0.62 x 109/l to 0.28 x 109/l (p < 0.01), normalization of eosinophilic neurotoxin level in stool – 93 ng/g of stool (p < 0.01) was observed.
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