Scleroderma-like esophageal disease in CHILDREN breast-fed

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1: JAMA. 1994 Jan 19;271(3):213-6.Links

Erratum in: JAMA 1994 Sep 14;272(10):770.

Sclerodermalike esophageal disease in children breast-fed by mothers with silicone breast implants.

Levine JJ, Ilowite NT.

Division of Pediatric Gastroenterology, Schneider Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11042.OBJECTIVE--To determine whether breast-fed children of mothers with silicone implants are at increased risk for the development of sclerodermalike esophageal involvement compared with children not exposed to silicone implants. DESIGN--Case-series [corrected]. SETTING--Referral-based pediatric gastroenterology clinic. PATIENTS--Eleven children (mean age, 6.0 years; range, 1.5 to 13 years; six boys and five girls) referred for abdominal pain who were born to mothers who had silicone breast implants (eight breast-fed children and three bottle-fed) were compared with 17 patients (mean age, 10.7 years; range, 2 to 18 years; 11 boys and six girls) with abdominal pain who were not exposed to silicone implants. METHODS--All children underwent esophageal manometry and upper intestinal endoscopy with esophageal biopsy and were tested for antinuclear antibody and autoantibodies to Scl-70, centromere, ribonucleoprotein, Sm, Ro, La, and phospholipid. RESULTS--Six of the eight breast-fed children from mothers with silicone implants had significantly abnormal esophageal motility with nearly absent peristalsis in the distal two thirds of the esophagus and decreased lower sphincter pressure. Upper esophageal pressures and motility were normal. Compared with controls, the breast-fed children had significantly decreased lower sphincter pressure and abnormal esophageal wave propagation. These manometric abnormalities were not seen in the three bottle-fed children. There was no difference in the expression of autoantibodies in the breast-fed children compared with the bottle-fed children or controls. CONCLUSIONS--A relationship appears to exist between breast-feeding by mothers with silicone implants and abnormal esophageal motility. Studies evaluating larger numbers of children are needed to determine the extent of the risk.PMID: 8277548 [PubMed - indexed for MEDLINE]

Sclerodermalike esophageal disease in children bre...[JAMA. 1994] - PubMed Result

1: Dig Dis Sci. 1996 Aug;41(8):1600-3.Links

Esophageal dysmotility in children breast-fed by mothers with silicone breast implants. Long-term follow-up and response to treatment.

Levine JJ, Trachtman H, Gold DM, Pettei MJ.

Division of Gastroenterology and Nutrition, Schneider Children's Hospital, Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA.Our aims were to determine the long-term clinical and manometric follow-up of 11 children with previously documented esophageal dysmotility, who had been breast-fed by mothers with silicone breast implants, their response to prokinetic agents, and to analyze changes in macrophage activation. Seven of 11 children had subjective clinical improvement. Weight/ height ratios remained the same or improved in 9/11. Biopsies at follow-up endoscopy were either normal or demonstrated mild esophagitis in 8/10. LES and UES pressures and percent propagation were not significantly different at follow-up, while wave amplitude significantly increased. Following intravenous metoclopramide, LES pressure, percent propagation, and wave amplitude significantly increased while UES pressure was unchanged. Urinary neopterin significantly decreased at follow-up, while urinary nitrates were unchanged. Esophageal dysmotility is chronic in this group of children, suggesting persistent autonomic nervous system dysfunction. Prokinetic agents may be useful in long-term management. The decreasing urinary neopterin levels suggest that, ultimately, there may be improvement in esophageal motility.PMID: 8769286 [PubMed - indexed for MEDLINE]

Esophageal dysmotility in children breast-fed by m...[Dig Dis Sci. 1996] - PubMed Result

SO MANY CHILDREN ARE AFFECTED , IT IS HORRIBLY SAD........

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