Ammar El Kheir¹ and Chadi Al Alam²*

¹Pediatrics, Pediatric Pulmonary and Allergic Diseases, Saudi German Hospital, Dammam, KSA
²Pediatrics and Pediatric Neurology, American Center for Psychiatry and Neurology - ACPN, Abu Dhabi, UAE

*Corresponding Author: Chadi Al Alam, Pediatrics and Pediatric Neurology, American Center for Psychiatry and Neurology - ACPN, Abu Dhabi, UAE.

Received: October 14, 2022; Published: November 04, 2022

Abstract

We present a case of 3-year-old pediatric Lebanese patient who initially presented to the clinic because of severe and persistent cow’s milk allergy since age of 3 days, and a 6-month-old Belgian pediatric patient with the same symptoms since the age of 3 months. Symptoms were consistent of only gastro-intestinal manifestations in the Lebanese patient, but the symptoms were more severe in the Belgian patient with hypoglycemia, eczema, and failure to thrive. Investigations showed IgE sensitization for milk and egg in the Belgian child and only to milk in the Lebanese child and both patients were diagnosed initially with Cow’s milk protein allergy until the diagnosis of food protein induced enterocolitis syndrome was made.

Keywords: Food Protein Induced Enterocolitis Syndrome; Cow’s Milk Allergy; Immunoglobulin E; Recurrent Vomiting

Bibliography

1. Boyce JA., et al. “Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report”. Journal of Allergy and Clinical Immunology 126 (2010): 1105-1118.
2. Powell GK. “Milk- and soy-induced enterocolitis of infancy”. Journal of Pediatrics 93 (1978): 553-560.
3. Mehr S., et al. “Food protein-induced enterocolitis syndrome: 16-year experience”. Pediatrics 123 (2009): e459-e64.
4. Sopo SM., et al. “A multicenter retrospective study of 66 Italian children with food protein-induced enterocolitis syndrome: different management for different phenotypes”. Clinical and Experimental Allergy 42 (2012): 1257-1265.
5. Nowak-Wegrzyn A., et al. “Food protein-induced enterocolitis syndrome caused by solid food proteins”. Pediatrics 111 (2003): 829-835.
6. Caubet JM FL., et al. “Clinical features, and resolution of food protein-induced enterocolitis syndrome: 10-year experience”. Journal of Allergy and Clinical Immunology (2014).
7. Ruffner MA., et al. “Food protein-induced enterocolitis syndrome: insights from review of a large referral population”. The Journal of Allergy and Clinical Immunology In Practice 1 (2013): 343-349.
8. Katz Y., et al. “The prevalence and natural course of food protein-induced enterocolitis syndrome to cow's milk: a large-scale, prospective population-based study”. Journal of Allergy and Clinical Immunology 127 (2011): 647-653.
9. Miyazawa T., et al. “Management of neonatal cow's milk allergy in high-risk neonates”. Pediatrics International 51 (2009): 544-547.
10. Miyazawa T., et al. “Retrospective Multicenter Survey on Food-Related Symptoms Suggestive of Cow's Milk Allergy in NICU Neonates”. Allergology International 62 (2013): 85-90.
11. Nowak-Wegrzyn A., et al. “International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: executive summary-Workgroup Report of the Adverse Reactions to Foods Committee". American Academy of Allergy, Asthma and Immunology”. Journal of Allergy and Clinical Immunology4 (2017): 1111-1126.
12. Berin MC., et al. “Acute FPIES reactions are associated with an IL-17 inflammatory signature”. Journal of Allergy and Clinical Immunology3 (2021): 895-901.e6.
13. Shimomura M., et al. “Increased serum cortisol on oral food challenge in infants with food protein-induced enterocolitis syndrome”. Pediatrics International1 (2018): 13-18.
14. Chung HL., et al. “Deposition of eosinophil-granule major basic protein and expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 in the mucosa of the small intestine in infants with cow’s milk-sensitive enteropathy”. Journal of Allergy and Clinical Immunology6 (1999): 1195-1201.
15. Ono HK., et al. “Histamine release from intestinal mast cells induced by staphylococcal enterotoxin A (SEA) evokes vomiting reflex in common marmoset”. PLoS Pathogen5 (2019): e1007803.
16. Greenhawt M., et al. “A validated index to measure health-related quality of life in patients with food protein- induced enterocolitis syndrome”. Journal of Allergy and Clinical Immunology4 (2014): 1251-1253.e5.

Citation: Ammar El Kheir and Chadi Al Alam. “Neonatal Food Protein Induced Enterocolitis Syndrome to Cow’s Milk with Delayed Diagnosis in Two Pediatric Patients 3.12 (2022): 04-07.

Copyright: © 2022 Ammar El Kheir and Chadi Al Alam. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.