title: Severe Food Protein-Induced Enterocolitis Syndrome to Cow's Milk in Infants.
abstract: Cow's milk is the most common cause of food-protein-induced enterocolitis syndrome (FPIES). The aim of this study was to examine the clinical features and treatment outcomes of infants with severe FPIES to cow's milk. We reviewed all infants ≤ 12 months of age who were hospitalized and diagnosed with severe FPIES to cow's milk between 1 January 2011 and 31 August 2014 in a tertiary Children's Medical Center in China. Patients' clinical features, feeding patterns, laboratory tests, and treatment outcomes were reviewed. A total of 12 infants met the inclusion criteria. All infants presented with diarrhea, edema, and hypoalbuminemia. Other main clinical manifestations included regurgitation/vomiting, skin rashes, low-grade fever, bloody and/or mucous stools, abdominal distention, and failure to thrive. They had clinical remission with resolution of diarrhea and significant increase of serum albumin after elimination of cow's milk protein (CMP) from the diet. The majority of infants developed tolerance to the CMP challenge test after 12 months of avoidance. In conclusion, we reported the clinical experience of 12 infants with severe FPIES to cow's milk, which resulted in malnutrition, hypoproteinemia, and failure to thrive. Prompt treatment with CMP-free formula is effective and leads to clinical remission of FPIES in infants.
authors.affiliation: Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China. ymlyxw@hotmail.com.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China. genglan_2001@hotmail.com.
authors.forename: Lanlan
authors.initials: L
authors.lastname: Geng
authors.affiliation: Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China. xuer_hui@126.com.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China. chenpei.y@163.com.
authors.forename: Peiyu
authors.initials: P
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Children's Mercy Hospital, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA. cfriesen@cmh.edu.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Friesen
authors.affiliation: Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China. sitangg@126.com.
authors.forename: Sitang
authors.initials: S
authors.lastname: Gong
authors.affiliation: Division of Gastroenterology, Children's Mercy Hospital, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA. dyli@cmh.edu.
authors.forename: Ding-You
authors.initials: DY
authors.lastname: Li
mesh_terms: D000818:Animals; D002417:Cattle; D002681:China; D003967:Diarrhea / Q000209:etiology; D004487:Edema / Q000209:etiology; D004760:Enterocolitis / Q000139:chemically induced / Q000150:complications / Q000178:diet therapy* / Q000276:immunology; D005183:Failure to Thrive / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology; D007108:Immune Tolerance; D007223:Infant; D041943:Infant Formula / Q000737:chemistry*; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008892:Milk; D016269:Milk Hypersensitivity / Q000150:complications / Q000178:diet therapy* / Q000473:pathology; D008894:Milk Proteins / Q000009:adverse effects / Q000276:immunology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013577:Syndrome
chemical_list: D008894:Milk Proteins
keywords: cow’s milk protein allergy; food-protein-induced enterocolitis syndrome; infants