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Non-infective colitis in infancy: evidence in favour of minor immunodeficiency in its pathogenesis
  1. Ayodele Ojuawo,
  2. Deborah St Louis,
  3. Keith J Lindley,
  4. Peter J Milla
  1. Gastroenterology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH
  1. Dr Lindley.

Abstract

Forty two infants below the age of 2 years presenting with chronic non-infective diarrhoea and shown to have histologically proved colitis were investigated over a five year period. Allergic colitis was the most common cause of colitis, accounting for 62% of the cases. Other colitides diagnosed included: non-specific colitis, autoimmune enterocolitis, and ulcerative colitis accounting for 10% each; severe combined immunodeficiency 7%, and Crohn’s disease 3%. A positive family history and a personal history of atopy were obtained in 48% and 29% of the cases respectively. Serum immunoglobulin A, IgG2, and IgG4 were very low in over 50% of the entire cohort of infants with colitis; 66% of those with severe combined immunodeficiency, autoimmune enterocolitis, and ulcerative colitis (n = 11) had low CD3 and CD4 T lymphocytes with an accompanying increase in CD8 in two thirds of those with severe combined immunodeficiency. T lymphocytes were normal in those with allergic colitis. Thus infants with proved non-infective colitis as a group show a high prevalence of IgA, IgG2, and IgG4 deficiency. It is likely that this minor deficiency of mucosa associated immunoglobulin production has a role in the pathogenesis of the colitic process.

  • infants
  • rectal bleeding
  • colitis
  • serum immunoglobulin A
  • immunoglobulin G subclasses
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