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[Physiologic nutritional evaluation of complete infant nutrition based on a soybean formula].

The purpose of this review is to evaluate the nutritional quality of soybean-based infant diets on the basis of results published in the scientific literature. Special consideration has been given to the use of soybean protein formulas for infants with reduced intestinal digestion and absorption capacity as well as in cases of cow's milk intolerance and allergic diseases.

Amino Acids↗

Inherited syndrome with corneal snowflake dystrophy, oculocutaneous pigmentary disturbances, pseudoexfoliation and malabsorption. Statistical data of some symptoms.

Corneal endothelial snowflake dystrophy was diagnosed in a child of 12 years as part of an inherited syndrome associated with various oculocutaneous pigmentation disturbances and malabsorption. Altogether 1,173 people were analyzed, 229 with the dystrophy and 944 controls. Snowflake dystrophy was associated with two kinds of intraocular pigment changes: the prevalence rate of green irides was 21.7% and the prevalence rate of large star-shaped chromatophore-like cells attached to the anterior lens capsule, 23.9%. These associations were statistically significant. The youngest people with green irides or pigmented cells were 14 and 15 years, respectively. After 50 years, the prevalence rates of these pigment changes decreased, and this was statistically significant. Snowflake dystrophy was also associated with malabsorption: the prevalence rate of milk intolerance was 37.6%, lactose malabsorption (hypolactasia) 39.0%, and vitamin A or fat malabsorption 23.3%. The associations between snowflake dystrophy, milk intolerance and hypolactasia were statistically significant.

Adolescent↗

Gastrointestinal occult hemorrhage and gastroduodenitis in cow's milk protein intolerance.

We are reporting on four infants with cow's milk protein intolerance who presented with hypochromic anemia and occult gastrointestinal hemorrhage. Esophagogastroduodenoscopy revealed erosive gastritis or gastroduodenitis in all cases. Management with a cow's milk-free diet led to a favorable clinical and hematological outcome; the endoscopic inflammatory image disappeared after the cow's milk-free diet trial. Challenge with cow's milk led to gastrointestinal symptoms and to impaired D-xylose absorption. The data presented suggest that some patients with cow's milk intolerance may have gastroduodenitis resulting in occult gastrointestinal hemorrhage and hypochromic anemia.

Anemia, Hypochromic↗

Influence of cow's milk proteins and gluten on human duodenal mucosa in organ culture.

Forty-five duodenal biopsies from 33 children and 3 adult patients were maintained in organ culture for 24 h and exposed to various cow's milk proteins and gluten. In 10 of 11 celiac patients with a flat duodenal mucosa, and in 2 of 4 patients with partial villous atrophy, a significant reduction in the mean enterocyte height was found after in vitro gluten exposure, compared to culture in basic culture medium. Three patients had coexisting celiac disease and cow's milk protein intolerance. alpha-Lactalbumin and beta-lactoglobulin exhibited toxic effects on flat biopsies from two of these patients, and casein was toxic in one. In 10 patients with cow's milk protein intolerance, a significant reduction in enterocyte height was noted in one case with gluten, and in three patients with casein and lactoglobulin, whereas lactalbumin did not affect the tissues. In seven control patients having a normal duodenal mucosa, no in vitro influences were noted, whereas in four patients with partial villous atrophy, a toxic reaction to gluten was seen in one and a reduced enterocyte height was seen after lactoglobulin exposure in another. In vitro toxicity induced by gluten corresponded well with the diagnosis of celiac disease, whereas toxic reactions to cow's milk proteins during organ culture were inconsistent in cow's milk intolerance, except for cases in which a marked enteropathy was documented.

Adolescent↗