title: [An acute vomiting infant with profuse diarrhoea: enterocolitis due to non-IgE-mediated cow's milk allergy].
abstract: BACKGROUND
  Food protein-induced enterocolitis is a manifestation of non-IgE-mediated cow's milk allergy, characterized by acute vomiting and profuse diarrhoea. This reaction is often not recognized as cow's milk allergy.
  
  
  METHODS
  We present a 6-week-old, formula-fed girl with frequent vomiting, diarrhoea and failure to thrive. These symptoms disappeared after giving cow's milk-free formula. Forty-five minutes after the last dose in a non-blinded provocation test with cow's milk, she developed profuse diarrhoea and vomiting, resulting in hypovolemic shock. No specific IgE against cow's milk was found.
  
  
  CONCLUSIONS
  Unusual in this case is the severe but relatively late reaction to the provocation test. In an acutely ill infant with vomiting, diarrhoea and pallor - which can even result in shock - food protein-induced enterocolitis as manifestation of non-IgE-mediated allergy must be considered. These symptoms start as late as 2 to 3 hours after exposure and disappear after withdrawal of the causal product.
authors.affiliation: Albert Schweitzer ziekenhuis, afd. Kindergeneeskunde, Dordrecht.
authors.forename: Esther
authors.initials: E
authors.lastname: van Puffelen
authors.forename: A W Wilma
authors.initials: AW
authors.lastname: Vriesman
authors.forename: Amerik C
authors.initials: AC
authors.lastname: de Mol
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Roosen
mesh_terms: D000818:Animals; D002417:Cattle; D003967:Diarrhea / Q000175:diagnosis* / Q000209:etiology; D004760:Enterocolitis / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007223:Infant; D041943:Infant Formula; D016269:Milk Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D008894:Milk Proteins / Q000276:immunology*; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology
chemical_list: D008894:Milk Proteins; D007073:Immunoglobulin E