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 and absence of ova and parasites
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
Other tests
- Serum IgE test against the offending food protein is usually negative
- Atypical-pANCA antibodies of IgG may be seen in some patient. This is however not pathognomonic of allergic colitis
References
- ↑ 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.
- ↑ 2.0 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.
- ↑ 3.0 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.