title: Echocardiographic alterations in a child with cow's milk allergy: a case report.
abstract: BACKGROUND
  Cow's milk allergy is the most frequent food allergy in Europe and western countries and shows a wide spectrum of clinical features, including atopic dermatitis and gastrointestinal disease. To the best of our knowledge, this report is the first to describe Kawasaki disease-like clinical features and echocardiographic alterations which resolved after a cow's milk-free diet.
  
  
  METHODS
  We report a case of a 9-month-old Caucasian girl with atopic dermatitis who developed clinical features commonly present in Kawasaki disease (erythematous skin rash, non-exudative conjunctivitis, fissured lips and neck lymph nodes), together with mild echocardiographic alterations (perivascular brightness, pericardial effusion) in the absence of fever. These features resolved within 2 weeks after the beginning of a cow's milk-free diet.
  
  
  CONCLUSIONS
  Kawasaki disease has recently been considered a possible risk factor for subsequent allergic disease secondary to immune dysfunction. This case report suggests that the immune-related alterations which are commonly present in allergic patients could be similar to the antigen-related immune response in Kawasaki disease and thus could lead to similar clinical features.
authors.affiliation: Servizio di Immuno-Allergologia Pediatrica, University of Perugia, Perugia, 06100, Italy. giu.dicara@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Cara
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Berioli
authors.forename: Anna
authors.initials: A
authors.lastname: Biscarini
authors.forename: Claudia
authors.initials: C
authors.lastname: Soldani
authors.forename: Piera
authors.initials: P
authors.lastname: Abate
authors.forename: Eleonora
authors.initials: E
authors.lastname: Ugolini
authors.forename: Giusiana
authors.initials: G
authors.lastname: Allocca
authors.forename: Maddalena
authors.initials: M
authors.lastname: Milioni