Predictors of High Serum Casein Antibody Levels among Malnourished Infants and Young Children with Congenital Heart Disease.
BACKGROUND
Factors predictive of growth retardation and malnutrition in patients with congenital heart disease remain unclear.


OBJECTIVE
This study aimed to measure antibody response to bovine casein through assessing serum casein antibody levels in malnourished patients three year or younger with CHD, and to determine its relationship to gastrointestinal symptoms, anthropometric measures, and laboratory data.


METHODS
This cross sectional case control study was conducted in sixty patients with CHD aged 4 to 72 months. They were subdivided into thirty patients with cyanotic and thirty patients with acyanotic CHD compared with thirty apparently healthy children.


RESULTS
On comparison with controls, patients showed highly significant lower anthropometric measures, calcium, iron, hemoglobin levels, and higher serum levels of casein antibody, total iron binding capacity, and alkaline phoshatase activity (P<0.000). Serum levels of casein antibody showed significantly positive correlations with serum total iron binding capacity and alkaline phosphatase activities and negatively correlated with the age at onset of symptoms, anthropometric measures, serum calcium, and iron levels.


CONCLUSIONS
Serum casein antibody levels play a significant role in the pathogenesis of malnutrition. Encouragement of breast feeding and avoidance of early cow's milk consumption could prevent the development of antibody response to bovine casein.
Child Health Department, National Research Centre, Cairo, Egypt.
Inas R
IR
El-Alameey
Hormones Department, National Research Centre, Cairo, Egypt.
Hanaa H
HH
Ahmed
Child Health Department, National Research Centre, Cairo, Egypt.
Zeinab M
ZM
Monir
Public Health and Community Medicine, National Research Centre, Cairo, Egypt.
Thanaa M
TM
Rabah
Child Health Department, National Research Centre, Cairo, Egypt.
Ayman M Abdel
AM
Gawad
congenital heart disease; malnourished infants; predictors; serum casein antibody; young children