Do Pre‐ and Postchallenge Small Intestinal Biopsies Help to Diagnose Cow's Milk Protein Intolerance?

Berg, N. O., Jakobsson, I. and Lindberg, T. (Department of Paediatrics, Malmö General Hospital, and Department of Pathology, University of Lund, Sweden). Do pre‐ and postchallenge small intestinal biopsies help to diagnose cow's milk protein intolerance? Acta Paediatr Scand, 68: 657, 1979.—Twelve infants suspected of cow's milk protein intolerance were challenged with cow's milk after at least one month of cow's milk‐free diet. The challenge was clinically positive in seven. Small intestinal biopsies were taken with a multipurpose capsule both pre‐ and postchallenge (at 24 h) in eight, prechallenge in three, and postchallenge in one. Two or three biopsy specimens were taken at the same time in 15 of the 20 biopsy occasions. The morphology of the mucosa could vary from normal to slight damage at the same biopsy occasion. No difference was found in morphology judged by light microscopy between pre‐ and postchallenged biopsies. Light microscopy of small intestinal biopsies taken before and at 24 h after milk challenge seems of doubtful value as a routine diagnostic means in cow's milk protein intolerance.