1.
[Anaphylaxis in a lactating infant who is allergic to cow's milk protein].
Calle, A, Chinchilla, C, Cardona, R
Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993). 2019;(1):123-127
Abstract
BACKGROUND Allergy to cow's milk protein is a common problem in children. The clinical manifestations of the reactions that are mediated by IgE are varied and the anaphylactic reactions can be life-threatening. CLINICAL CASE A girl at an age of four months and a half that, five minutes after consuming cereal with cow's milk, had rashes in the perioral area and extensive pruritic micropapular lesions associated with vomit and inspiratory stridor. She received adrenaline by intramuscular injection and antihistamines by intravenous injection. She was first evaluated in a service of allergy treatment when she was six months and twenty days old. The results of the allergen-specific immunoglobulin E test were positive. The treatment was initiated with a hydrolyzed rice formula and supplementary feeding. CONCLUSIONS Anaphylaxis can be the first and last manifestation of a food allergy. The right education for parents about strictly avoiding the food that triggered the allergic reaction and the right training in the use of intramuscular adrenalin may result in a better prognosis for patients.
2.
Identification of the first patient with a confirmed mutation of the JAK-STAT system.
Rosenfeld, RG, Kofoed, E, Buckway, C, Little, B, Woods, KA, Tsubaki, J, Pratt, KA, Bezrodnik, L, Jasper, H, Tepper, A, et al
Pediatric nephrology (Berlin, Germany). 2005;(3):303-5
Abstract
Growth hormone insensitivity (GHI) has been attributable, classically, to mutations in the gene for the GH receptor. After binding to the GH receptor, GH initiates signal transduction through a number of pathways, including the JAK-STAT pathway. We describe the first patient reported with a mutation in the gene for STAT5b, a protein critical for the transcriptional regulation of insulin-like growth factor-I.
3.
Cow's milk allergy in a patient with hyper-IgE syndrome.
Hernandez-Trujillo, VP, Nguyen, WT, Belleau, JT, Jeng, M, Conley, ME, Lew, DB
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2004;(4):469-74
Abstract
BACKGROUND Both hyper-IgE syndrome and food allergies can result in the early onset of skin rash, eosinophilia, and markedly elevated serum IgE. Occasionally, it can be difficult to distinguish the 2 disorders. Most patients with hyper-IgE syndrome do not have food allergy. OBJECTIVE To describe a child with cow's milk allergy associated with hyper-IgE syndrome manifesting as failure to thrive (FTT). METHODS Epicutaneous skin prick test to cow's milk, CAP radioallergosorbent test, atopy patch tests, and double-blind, placebo-controlled milk challenge (DBPCMC) were performed. RESULTS During initial presentation at 3 weeks of age, the circulating eosinophil count increased from 13,800/mm3 to 44,254/mm3 within 2 weeks while taking cephalexin. Despite treatment, he had worsening rash and FTT at 10 weeks of age with an IgE level of 8,454 U/mL. After changing from an infant milk formula with whey protein to an amino acid-based formula in combination with oral antibiotic treatment, his rash and growth velocity improved markedly within 2 months. IgE decreased to 2,747 U/mL. He remained clinically well for 12 months. He subsequently developed additional food and inhalant allergies with an increase in IgE to 12,150 U/mL. Cow's milk allergy was confirmed by epicutaneous skin prick test, atopy patch test, and DBPCMC. CONCLUSIONS Traditional prophylactic antistaphylococcal antibiotics, in combination with Neocate formula, were effective in treating the early skin manifestations of hyper-IgE syndrome and FTT in this infant. Cow's milk protein allergy should be considered in patients with hyper-IgE syndrome and FTT.
4.
Food protein-induced enterocolitis syndrome: report of one case.
Marr, HY, Chen, WC, Lin, LH
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi. 2001;(1):49-52
Abstract
We report a 76-day old infant who got diarrhea within the first week of life. He was treated as acute gastroenterocolitis and kept on feeding with regular infant formula. Because the symptoms persisted, the feeding formula was shifted to soy-based formula then to the highly-hydrolyzed formula and got improvement. But severe bloody diarrhea, vomiting, dehydration and fever developed after feeding with regular infant formula again. Based on the history and clinical presentations, cow's milk allergy was suspected. He received total parenteral nutrition for 5 days then fed with highly-hydrolyzed formula with slowly increasing amount. Thereafter tests for total eosinophil counts, total serum IgE, milk specific IgE antibodies and milk extract skin prick test were all unremarkable. Under the impression of food protein-induced enterocolitis syndrome (FPIES), a double-blind placebo-controlled food challenge (DBPCFC) with infant formula was performed. Regular infant formula induced severe vomiting, diarrhea, fever, acidosis and elevation of absolute neutrophil counts (ANC) of peripheral blood by 27,640/mm3. Based on the laboratory findings and challenge results, the patient fit the diagnostic criteria of food protein-induced enterocolitis syndrome.