›› 2014, Vol. 32 ›› Issue (11): 1072-.doi: 10.3969 j.issn.1000-3606.2014.11.018

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Food protein-induced enterocolitis syndrome caused by cow's milk protein allergy in an infant: case report and review of literature

Fang Tiefu, Yang Min, Gong Sitang, Chen Peiyu, Geng Lanlan, Xu Zhaohui, Liang Cuiping, Li Huiwen, He Waner   

  1. Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou 510623,Guangdong, China
  • Received:2014-11-15 Online:2014-11-15 Published:2014-11-15

Abstract: To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding difficulty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-specific IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of “necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein rechallenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-specific and variable clinical symptoms and signs, and should be considered in the differential diagnosis.