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Korean J Pediatr 1995 July;38(7) :936-945.
Intractable Diarrhea in Early Infancy : Clinical Features on Admission and A Nutritional Management
Jong Won Shin (Shin JW), Kyung Won Hwang (Hwang KW), Young Ho Ahn (Ahn YH), Jin Bok Hwang (Hwang JB), Chang Ho Han (Han CH), Hai Lee Chung (Chung HL), Young Dae Kwon (Kwon YD)
Department of Pediatrics, Taegu Catholic University School of Medicine, Taegu, Korea
Copyright © 1995 by The Korean Pediatric Society
Purpose : We studied to assess the value of clinical findings on admission in screening of intractable diarrhea in early infancy(IDI) and the efficiency of early trial of semi-elemental form-ula (protein hydrolysate) as a nutritional management in IDI. Methods : We carried out a retrospective review of medical records of twenty-eight early infants with diarrhea and malnutrition who were diagnosed as IDI at Department of Pediatrics, Taegu Catholic University Hospital between January 1990 and May 1993. Results : 1) The mean age of the patients was 28.914.5(10 - 86)days. The duration of diarrhea on admission was 66.1(1 - 30)days. Twenty-four cases(85%) were below 3 percentile in body weight on admission and no patients was fed breast milk over 7 days after birth. 2) Laboratory data on admission showed serum protein level 4.80.5(3.7 - 6.1) g/dl, serum albumin level 2.20.3(1.8 - 3.3)g/dl, serum bicarbonate level 11.35.7(2.7 - 22.3) mEq/L and band form of leukocytes on the peripheral blood smear was 23.715.6(4 - 64) %. 3) Necrotizing enterocolitis was developed in 5(18%) cases and the incidence was much more common in patients with 'Not-Tried' or 'Not-Early Tried' of semi-elemental formula as a nutritional management(p<0.05). 4) 'Early Tried' patients with semi-elementa formula showed rapid improvement in body weight and thriving, early remission, lower incidence of necrotizing enterocolitis and motality than other groups(p<0.05). Conclusion : IDI must be considered and early trial of semi-elemental formula can be recommended if a young infant suffered from diarrhea and malnutrition shows features of body weight<3 percentile serum albumin<3.0g/dl band neutrophil>5% on peripheral blood smear on admission.
Keywords: Early infancy | Intractable | Diarrhea | Protein hydrolysate
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A Follow-Up Study of Intractable Diarrhea in Early Infancy: Clinical Features of Cow's Milk Allergy and Cow Milk-Sensitive Enteropathy  1995 November;38(11)
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