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Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation
A cellular proliferation to milk allergens has been found in the cord blood cells of neonates. While this reflects a sensitivity during the fetal life, its clinical significance and disease, particularly its unconventional presentations, have remained largely unrecognized by care providers. Here, we...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9051367/ https://www.ncbi.nlm.nih.gov/pubmed/35498816 http://dx.doi.org/10.3389/fped.2022.858476 |
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author | Madala, Akshita Lure, Allison C. Cheng, Svea Cheng, Sam X. |
author_facet | Madala, Akshita Lure, Allison C. Cheng, Svea Cheng, Sam X. |
author_sort | Madala, Akshita |
collection | PubMed |
description | A cellular proliferation to milk allergens has been found in the cord blood cells of neonates. While this reflects a sensitivity during the fetal life, its clinical significance and disease, particularly its unconventional presentations, have remained largely unrecognized by care providers. Here, we report three cases of infants whose mothers consumed dairy products during pregnancy, who developed a severely constipated pre- and postnatal bowel. The passage of meconium was significantly delayed with subsequent early-onset infant constipation that was intractable to conventional therapies but remitted when milk proteins were withheld, recurred when milk proteins were reintroduced, and resolved again when switched to an extensively hydrolyzed or amino acid-based infant formula. Based on this and other observations, it is believed that these infants must have initiated and/or developed cow's milk protein allergy prenatally during fetal life. We suggest that a 2-week trial of cow's milk protein avoidance be applied to these neonate infants with early-onset constipation before an unnecessary invasive work-up for Hirschsprung disease and others is initiated per the current guidelines. |
format | Online Article Text |
id | pubmed-9051367 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90513672022-04-30 Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation Madala, Akshita Lure, Allison C. Cheng, Svea Cheng, Sam X. Front Pediatr Pediatrics A cellular proliferation to milk allergens has been found in the cord blood cells of neonates. While this reflects a sensitivity during the fetal life, its clinical significance and disease, particularly its unconventional presentations, have remained largely unrecognized by care providers. Here, we report three cases of infants whose mothers consumed dairy products during pregnancy, who developed a severely constipated pre- and postnatal bowel. The passage of meconium was significantly delayed with subsequent early-onset infant constipation that was intractable to conventional therapies but remitted when milk proteins were withheld, recurred when milk proteins were reintroduced, and resolved again when switched to an extensively hydrolyzed or amino acid-based infant formula. Based on this and other observations, it is believed that these infants must have initiated and/or developed cow's milk protein allergy prenatally during fetal life. We suggest that a 2-week trial of cow's milk protein avoidance be applied to these neonate infants with early-onset constipation before an unnecessary invasive work-up for Hirschsprung disease and others is initiated per the current guidelines. Frontiers Media S.A. 2022-04-15 /pmc/articles/PMC9051367/ /pubmed/35498816 http://dx.doi.org/10.3389/fped.2022.858476 Text en Copyright © 2022 Madala, Lure, Cheng and Cheng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Madala, Akshita Lure, Allison C. Cheng, Svea Cheng, Sam X. Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation |
title | Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation |
title_full | Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation |
title_fullStr | Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation |
title_full_unstemmed | Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation |
title_short | Case Reports of Cow's Milk Protein Allergy Presenting as Delayed Passage of Meconium With Early Onset Infant Constipation |
title_sort | case reports of cow's milk protein allergy presenting as delayed passage of meconium with early onset infant constipation |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9051367/ https://www.ncbi.nlm.nih.gov/pubmed/35498816 http://dx.doi.org/10.3389/fped.2022.858476 |
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