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Unusual Presentation of Cow’s Milk Protein Allergy

Cow’s milk protein allergy (CMPA) is an abnormal immunologic response to bovine protein that can result in various gastrointestinal and cutaneous manifestations including diarrhea, failure to thrive, malabsorption, and even protein-losing enteropathy. We describe a case of a 7-month-old breastfed ma...

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Autores principales: Cresoe, Samantha, Setya, Aniruddh, Beasley, Genie, Gonzalo, David Hernandez, Chan, Albert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158318/
https://www.ncbi.nlm.nih.gov/pubmed/37168480
http://dx.doi.org/10.1097/PG9.0000000000000246
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author Cresoe, Samantha
Setya, Aniruddh
Beasley, Genie
Gonzalo, David Hernandez
Chan, Albert
author_facet Cresoe, Samantha
Setya, Aniruddh
Beasley, Genie
Gonzalo, David Hernandez
Chan, Albert
author_sort Cresoe, Samantha
collection PubMed
description Cow’s milk protein allergy (CMPA) is an abnormal immunologic response to bovine protein that can result in various gastrointestinal and cutaneous manifestations including diarrhea, failure to thrive, malabsorption, and even protein-losing enteropathy. We describe a case of a 7-month-old breastfed male who presented with severe atopic dermatitis, emesis, oily diarrhea, failure to thrive, electrolyte disturbance, and hemodynamic instability. Following stabilization, additional evaluation revealed concern for abetalipoproteinemia. Ultimately, the patient’s symptoms resolved with introduction of an elemental formula and returned with reinitiation of cow’s milk protein, confirming the diagnosis of severe CMPA. It is important for the general practitioner to be aware of the various presentations and have a high index of suspicion for CMPA as no symptom or diagnostic test is pathognomonic for diagnosis. Even though it can mimic other causes of malabsorption, a trial with extensively hydrolyzed or elemental formula should be attempted before undertaking invasive testing.
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spelling pubmed-101583182023-05-09 Unusual Presentation of Cow’s Milk Protein Allergy Cresoe, Samantha Setya, Aniruddh Beasley, Genie Gonzalo, David Hernandez Chan, Albert JPGN Rep Case Report Cow’s milk protein allergy (CMPA) is an abnormal immunologic response to bovine protein that can result in various gastrointestinal and cutaneous manifestations including diarrhea, failure to thrive, malabsorption, and even protein-losing enteropathy. We describe a case of a 7-month-old breastfed male who presented with severe atopic dermatitis, emesis, oily diarrhea, failure to thrive, electrolyte disturbance, and hemodynamic instability. Following stabilization, additional evaluation revealed concern for abetalipoproteinemia. Ultimately, the patient’s symptoms resolved with introduction of an elemental formula and returned with reinitiation of cow’s milk protein, confirming the diagnosis of severe CMPA. It is important for the general practitioner to be aware of the various presentations and have a high index of suspicion for CMPA as no symptom or diagnostic test is pathognomonic for diagnosis. Even though it can mimic other causes of malabsorption, a trial with extensively hydrolyzed or elemental formula should be attempted before undertaking invasive testing. Lippincott Williams & Wilkins, Inc. 2022-09-01 /pmc/articles/PMC10158318/ /pubmed/37168480 http://dx.doi.org/10.1097/PG9.0000000000000246 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Report
Cresoe, Samantha
Setya, Aniruddh
Beasley, Genie
Gonzalo, David Hernandez
Chan, Albert
Unusual Presentation of Cow’s Milk Protein Allergy
title Unusual Presentation of Cow’s Milk Protein Allergy
title_full Unusual Presentation of Cow’s Milk Protein Allergy
title_fullStr Unusual Presentation of Cow’s Milk Protein Allergy
title_full_unstemmed Unusual Presentation of Cow’s Milk Protein Allergy
title_short Unusual Presentation of Cow’s Milk Protein Allergy
title_sort unusual presentation of cow’s milk protein allergy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158318/
https://www.ncbi.nlm.nih.gov/pubmed/37168480
http://dx.doi.org/10.1097/PG9.0000000000000246
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