[Colitis induced by a food allergen. A report of 20 cases]. / Colitis inducida por alergeno alimentario. Presentación de 20 casos.

In the last years, we have appreciated a descending number of classic enteral food-protein intolerance and cases of colitis related to food proteins are increasing. In this study, 20 cases of food protein colitis (mainly related to cow's milk) are reviewed and clinical, endoscopic and histological aspects are analyzed. We found that the age at the time of the first consultation was approximately 1.5 months, with males predominating. The main symptom was bloody diarrhoea. Other causes such as perianal fissure or infectious gastroenteritis were excluded. The infants were fed breast milk and/or cow's milk formula. Some patients had low hemoglobin, but low serum albumin was infrequent. The colonoscopy showed erythema and, in some cases, loss of vascular pattern, ulcerations or bleeding. The main histological finding was an increased number of eosinophils. There was a favorable response to the dietary change. After 6 months, all of the provocations done were negative. We conclude that food-protein intolerance is one of the most probable causes of bloody stools in a young infant. Colonoscopy and a histopathological study of at least three biopsy pieces are necessary for the diagnosis. The treatment is the exclusion of the offending protein from the diet.

[Rheumatic fever and post-streptococcal arthritis. Clinical review]. / Fiebre reumática y artritis postestreptocócicas. Revisión clínica.

We report 11 patients diagnosed of Acute Rheumatic Fever (ARF), and 7 of Poststreptococcal Reactive Arthritis (PSRA): patients with group A beta hemolytic streptococcal infection and articular disease who do not fulfill the modified Jones criteria. All patients with ARF were treated with monthly prophylaxis (with penicillin G benzathine). Carditis was seen in five patients, but only one of them has developed a mitral valve insufficiency. The prophylaxis in patients with PSRA was individualized. None of these patients had clinical evidence of carditis during the acute disease, but one of them developed a mitral and aortic stenosis two years after the initial episode. The possible indication of penicillin prophylaxis in these patients with PSRA in suggested.