Allergic colitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]

Overview

There are no specific laboratory findings that are pathognomonic of allergic colitis. Laboratory studies should therefore be correlated with a carefully taken history and a detailed physical examination. Presence of eosinophils in the stool is suggestive of allergic colitis in the presence of typical clinical findings.[1][2][3]

Laboratory Findings

There are no specific diagnostic laboratory findings associated with allergic colitis. Laboratory studies should therefore be correlated with a carefully taken history and a detailed physical examination.[1][2][3]

Stool microscopy

  • Presence of blood, either frank or occult blood
  • May show increased eosinophils which is suggestive of allergic colitis in the presence of typical clinical findings

Complete Blood Count with Differentials and Peripheral Blood Smear

  • A low hemoglobin or hematocrit with microcytosis or marginal normocytosis may be seen and indicative of iron deficiency anemia from blood loss
  • Peripheral blood eosinophilia may rarely be seen especially in FPIES
  • Elevated white blood cells with a left shift may be seen in severe acute FPIES

Iron studies

  • Low ferritin with a high TIBC is suggestive of chronic blood loss by inflammatory bowel disease.
  • High ferritin may be suggestive of anemia of chronic inflammatory conditions

Complete Metabolic Panel

  • May show hypoalbuminemia especially in children with chronic FPIES
  • Metabolic acidosis may be seen in FPIES

References

  1. 1.0 1.1 Fiocchi A, Brozek J, Schünemann H, Bahna SL, von Berg A, Beyer K; et al. (2010). "World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines". Pediatr Allergy Immunol. 21 Suppl 21: 1–125. doi:10.1111/j.1399-3038.2010.01068.x. PMID 20618740.
  2. 2.0 2.1 Pumberger W, Pomberger G, Geissler W (2001). "Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood". Postgrad Med J. 77 (906): 252–4. PMC 1741985. PMID 11264489.
  3. 3.0 3.1 Nowak-Węgrzyn A (2015). "Food protein-induced enterocolitis syndrome and allergic proctocolitis". Allergy Asthma Proc. 36 (3): 172–84. doi:10.2500/aap.2015.36.3811. PMC 4405595. PMID 25976434.

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