LYMPHONODULAR HYPERPLASIA OF THE COLON AS A MANIFESTATION OF COWS MILK PROTEIN SENSITIVITY

An exclusively breast-fed infant is described presenting with gastrointestinal bleeding and an eosinophilic colitis. Symptoms disappeared and histology normalized with a hydrolyzated semi-elemental diet. Rectal bleeding reappeared with a hydrolyzated hypoallergenic formula, and endoscopy and histology showed a lymphonodular hyperplasia disappearing when the semi-elemental diet was re-instated. At the age of 1 year, cow's milk proteins were still not tolerated. Two similar cases were observed with a cow's milk protein related colic lymphoid hyperplasia. We conclude that lymphoid hyperplasia could be a pathological finding in infants suffering from rectal bleeding. The observations suggest that in some infants lymphoid hyperplasia can be related to the ingestion of cow's milk proteins, and stress the importance of colonscopy in the diagnosis of cow's milk protein sensitivity.