Lower Gastrointestinal Bleeding, Vomiting, and Weight Stagnation in a Well-Appearing Neonate with Neonatal Transient Eosinophilic Gastroenterocolitis

 

 Permissions and Reprints

Abstract

This study presents a novel case of neonatal transient eosinophilic gastroenterocolitis, a proposed new entity causing upper and lower digestive symptoms and extensive gastrointestinal eosinophilic infiltration in newborns without a proven active food allergy. The condition's proposed pathophysiology and relationship to similar conditions, alongside clinical and therapeutic approaches, are also discussed.

Publication History

Received: 20 November 2024

Accepted: 23 January 2025

Accepted Manuscript online:
04 February 2025

Article published online:
20 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

• References

• 1 Romano C, Oliva S, Martellossi S. et al. Pediatric gastrointestinal bleeding: perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol 2017; 23 (08) 1328-1337
  CrossrefPubMedSearch in Google Scholar
• 2 Debuf MJ, Claeys T, Stalens JP, Cornette L. Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report. J Med Case Rep 2017; 11 (01) 160
  CrossrefPubMedSearch in Google Scholar
• 3 Ohtsuka Y, Shimizu T, Shoji H. et al. Neonatal transient eosinophilic colitis causes lower gastrointestinal bleeding in early infancy. J Pediatr Gastroenterol Nutr 2007; 44 (04) 501-505
  CrossrefPubMedSearch in Google Scholar
• 4 Schoemaker AA, Sprikkelman AB, Grimshaw KE. et al. Incidence and natural history of challenge-proven cow's milk allergy in European children–EuroPrevall birth cohort. Allergy 2015; 70 (08) 963-972
  CrossrefPubMedSearch in Google Scholar
• 5 Jang HJ, Kim AS, Hwang JB. The etiology of small and fresh rectal bleeding in not-sick neonates: should we initially suspect food protein-induced proctocolitis?. Eur J Pediatr 2012; 171 (12) 1845-1849
  CrossrefPubMedSearch in Google Scholar
• 6 Yamada Y. Recent topics on gastrointestinal allergic disorders. Clin Exp Pediatr 2023; 66 (06) 240-249
  CrossrefPubMedSearch in Google Scholar
• 7 Dellon ES, Gonsalves N, Abonia JP. et al. International consensus recommendations for eosinophilic gastrointestinal disease nomenclature. Clin Gastroenterol Hepatol 2022; 20 (11) 2474-2484.e3
  CrossrefPubMedSearch in Google Scholar
• 8 Papadopoulou A, Amil-Dias J, Auth MK. et al. Joint ESPGHAN/NASPGHAN guidelines on childhood eosinophilic gastrointestinal disorders beyond eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2024; 78 (01) 122-152
  CrossrefPubMedSearch in Google Scholar
• 9 Al-Iede M, Sarhan L, Alshrouf MA, Said Y. Perspectives on non-IgE-mediated gastrointestinal food allergy in pediatrics: a review of current evidence and guidelines. J Asthma Allergy 2023; 16: 279-291
  CrossrefPubMedSearch in Google Scholar
• 10 Campora M, Mastracci L, Carlin L. et al. Pathologist's approach to paediatric and neonatal eosinophilic gastrointestinal disorders. Pathologica 2022; 114 (01) 79-88
  CrossrefPubMedSearch in Google Scholar
• 11 Nomura I, Morita H, Hosokawa S. et al. Four distinct subtypes of non-IgE-mediated gastrointestinal food allergies in neonates and infants, distinguished by their initial symptoms. J Allergy Clin Immunol 2011; 127 (03) 685-8.e1 , 8
  CrossrefPubMedSearch in Google Scholar
• 12 Mennini M, Fiocchi AG, Cafarotti A. et al. Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol. World Allergy Organ J 2020; 13 (10) 100471
  CrossrefPubMedSearch in Google Scholar
• 13 Hoshi K, Mukai T, Kumasawa K, Takahashi N. Case report: Neonatal case of intrauterine gastrointestinal bleeding with suspected cow's milk allergy or neonatal transient eosinophilic colitis. Front Pediatr 2023; 11: 1213782
  CrossrefPubMedSearch in Google Scholar
• 14 Ota S, Adachi H, Noguchi A, Arai H, Takahashi T. Neonatal transient eosinophilic colitis with single bubble sign. Pediatr Int 2018; 60 (12) 1092-1093
  CrossrefPubMedSearch in Google Scholar
• 15 Tanaka K, Koshida S, Yanagi T. et al. Suspected fetal onset of neonatal transient eosinophilic colitis and development of respiratory distress. Pediatr Int 2015; 57 (04) 734-738
  CrossrefPubMedSearch in Google Scholar
• 16 Senocak N, Ertugrul A, Ozmen S, Bostanci I. Clinical features and clinical course of food protein-induced allergic proctocolitis: 10-year experience of a tertiary medical center. J Allergy Clin Immunol Pract 2022; 10 (06) 1608-1613
  CrossrefPubMedSearch in Google Scholar
• 17 Juul SE, Haynes JW, McPherson RJ. Evaluation of eosinophilia in hospitalized preterm infants. J Perinatol 2005; 25 (03) 182-188
  CrossrefPubMedSearch in Google Scholar
• 18 Sullivan SE, Calhoun DA. Eosinophilia in the neonatal intensive care unit. Clin Perinatol 2000; 27 (03) 603-622 , vi
  CrossrefPubMedSearch in Google Scholar
• 19 Kimura M, Shimomura M, Morishita H, Meguro T, Seto S. Eosinophilia in infants with food protein-induced enterocolitis syndrome in Japan. Allergol Int 2017; 66 (02) 310-316
  CrossrefPubMedSearch in Google Scholar
• 20 Suzuki H, Tsutsumi Y, Morita H. et al. Cord blood eosinophilia precedes neonatal onset of food-protein-induced enterocolitis syndrome (FPIES). Allergol Int 2021; 70 (02) 262-265
  CrossrefPubMedSearch in Google Scholar
• 21 Borres MP, Odelram H, Irander K, Kjellman NI, Björkstén B. Peripheral blood eosinophilia in infants at 3 months of age is associated with subsequent development of atopic disease in early childhood. J Allergy Clin Immunol 1995; 95 (03) 694-698
  CrossrefPubMedSearch in Google Scholar
• 22 Mori M, Ohtsuka Y, Ishida A. et al. Outcome of infants presenting rectal bleeding: a retrospective study in a single institution. Pediatr Int 2014; 56 (06) 884-890
  CrossrefPubMedSearch in Google Scholar
• 23 Hwang JB, Hong J. Food protein-induced proctocolitis: is this allergic disorder a reality or a phantom in neonates?. Korean J Pediatr 2013; 56 (12) 514-518
  CrossrefPubMedSearch in Google Scholar
• 24 D'Auria E, Cavigioli F, Acunzo M. et al. Food-protein-induced proctocolitis in pre-term newborns with bloody stools in a neonatal intensive care unit. Nutrients 2024; 16 (17) 3036
  CrossrefPubMedSearch in Google Scholar
• 25 Suzuki H, Morisaki N, Nagashima S. et al. A nationwide survey of non-IgE-mediated gastrointestinal food allergies in neonates and infants. Allergol Int 2024; 73 (02) 264-274
  CrossrefPubMedSearch in Google Scholar
• 26 Morita H, Suzuki H, Orihara K. et al. Food protein-induced enterocolitis syndromes with and without bloody stool have distinct clinicopathologic features. J Allergy Clin Immunol 2017; 140 (06) 1718-1721.e6
  CrossrefPubMedSearch in Google Scholar
• 27 Schibler KR, Christensen RD. Eosinophils and Neutrophils. In: De Alarcón PA, Werner EJ, Christensen RD, Sola-Visner MC. eds. Neonatal Hematology: Pathogenesis, Diagnosis, and Management of Hematologic Problems. Cambridge: Cambridge University Press; 2021: 261-278
  Search in Google Scholar
• 28 Yang JY, Cha J, Shim SY, Cho SJ, Park EA. The relationship between eosinophilia and bronchopulmonary dysplasia in premature infants at less than 34 weeks' gestation. Korean J Pediatr 2014; 57 (04) 171-177
  CrossrefPubMedSearch in Google Scholar
• 29 Shahein AR, Gonzalez S, Carcao M, Abdelhaleem M, Hellmann J, McNamara PJ. A case of severe eosinophilia in a preterm infant. Pediatrics 2011; 127 (03) e767-e771
  CrossrefPubMedSearch in Google Scholar
• 30 Morein B, Abusugra I, Blomqvist G. Immunity in neonates. Vet Immunol Immunopathol 2002; 87 (3-4): 207-213
  CrossrefPubMedSearch in Google Scholar
• 31 Basha S, Surendran N, Pichichero M. Immune responses in neonates. Expert Rev Clin Immunol 2014; 10 (09) 1171-1184
  CrossrefPubMedSearch in Google Scholar
• 32 Sproat T, Payne RP, Embleton ND, Berrington J, Hambleton S. T cells in preterm infants and the influence of milk diet. Front Immunol 2020; 11: 1035
  CrossrefPubMedSearch in Google Scholar