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Srpski arhiv za celokupno lekarstvo
2005, vol. 133, br. 7-8, str. 348-352
jezik rada: srpski
vrsta rada: članak
doi:10.2298/SARH0508348M


Kliničke manifestacije nepodnošenja proteina kravljeg mleka kod odojčadi
aZdravstveni centar, Valjevo
bUniverzitet u Beogradu, Medicinski fakultet, Univerzitetska dečija klinika
cPedijatrijska klinika, Kliničko-bolnički centar 'Kragujevac', Kragujevac
dUniverzitet u Beogradu, Medicinski fakultet, Institut za onkologiju i radiologiju Srbije

Sažetak

Uvod. Poremećaj podnošenja proteina kravljeg mleka odlikuje širok spektar kliničkih manifestacija izazvanih I, II ili III tipom hipersenzitivnosti. Ovaj poremećaj se javlja kod 2-3% dece, uglavnom u dojenačkoj dobi. Cilj rada. Cilj rada je bio da se prikažu naša iskustva i zapažanja u vezi s kliničkim simptomima i znacima nepodnošenja proteina kravljeg mleka kod odojčadi. Metod rada. U istraživanje je bilo uključeno 55 odojčadi kod kojih je nepodnošenje proteina kravljeg mleka dijagnostikovano u uzrastu od jednog i po meseca do devet meseci (4,21+1,25 meseci). Dijagnoza oboljenja se zasnivala na tipičnim anamneznim i kliničko-laboratorijskim parametrima, kao i adekvatnom odgovoru bolesnika na eliminaciju antigena. Rezultati. U kliničkoj prezentaciji nepodnošenja proteina kravljeg mleka Dominirale su kutane smetnje, koje su utvrđene kod 40 ispitanika (72,73%), potom digestivne smetnje, zabeležene kod 31 odojčeta (56,36%), dok su respiracione tegobe bile najređe (14,55%). Ni kod jednog ispitanika nije zabeležen anafilaktički šok. Promene jednog sistema ustanovljene su kod 35 ispitanika (63,64%), od čega kod 20 kutane (36,36%) a kod 15 digestivne (27,27%). Promene više sistema zabeležene su kod 20 ispitanika(36,36%),i to kod 12 kutano-digestivne, a kod po četiri kutano-respiracione i kutano-digestnevno-respiracione. Kod 26 odojčadi dijagnostikovana je urtikarija (47,27%), kod 22 ispitanika perioralni eritem (40,00%), kod 21 (38,18%) proliv(kod 15 hemoragijski a kod šest nehemoragijski), kod 13 ispitanika povraćanje (23,64%), kod po 12 bolesnika Keinkeov edem (21,82%) i ekcem (21,82%), kod pet opstrukcioni bronhitis (9,09%)i kod tri ispitanika laringitis (5,45%). Kod pet bolesnika utvrđen je značajan gubitak telesne težine (9,09%), kod tri bolesnika utvrđena je sideropenijska anemija (5,45%),dok zaostajanje u longitudinalnom rastu nije zabeleženo ni kod jednog odojčeta. Zaključak. Rezultati našeg istraživanja pokazuju da u poremećaju podnošenja proteina kravljeg mleka kod odojčadi preovlađuju kutane i kutano-digestivne smetnje, dok su respiracione tegobe relativno retke.

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