title: Gastrointestinal occult hemorrhage and gastroduodenitis in cow's milk protein intolerance.
abstract: We are reporting on four infants with cow's milk protein intolerance who presented with hypochromic anemia and occult gastrointestinal hemorrhage. Esophagogastroduodenoscopy revealed erosive gastritis or gastroduodenitis in all cases. Management with a cow's milk-free diet led to a favorable clinical and hematological outcome; the endoscopic inflammatory image disappeared after the cow's milk-free diet trial. Challenge with cow's milk led to gastrointestinal symptoms and to impaired D-xylose absorption. The data presented suggest that some patients with cow's milk intolerance may have gastroduodenitis resulting in occult gastrointestinal hemorrhage and hypochromic anemia.
mesh_terms: D000747:Anemia, Hypochromic / Q000209:etiology; D000818:Animals; D002417:Cattle; D004382:Duodenitis / Q000209:etiology*; D005260:Female; D005756:Gastritis / Q000209:etiology*; D006801:Humans; D007223:Infant; D007787:Lactose Intolerance / Q000150:complications* / Q000178:diet therapy; D008551:Melena / Q000209:etiology*; D014839:Vomiting / Q000209:etiology