Infantile hepatic dysfunction improved by elimination of cows’ milk formulas

Saito, Megumu K.; Obi, Makiko; Kimura, Mitsuaki

doi:10.1111/j.1399-3038.2005.00256.x

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…Some institutions chose failure to thrive or not doing well as important symptoms for identifying possible NMA. Independent of these symptoms, liver dysfunction with elevation of liver enzymes such as aspartate aminotransferase and alanine aminotransferase has been reported in NMA 17 . Therefore, in cases with liver dysfunction in which the patient shows a failure to thrive or is not doing well, differentiation of milk allergy from gastrointestinal diseases, infections and metabolic diseases is required.…”

Section: Discussionmentioning

confidence: 99%

“…Kimura et al. proposed that measurement of lymphocyte proliferation by flow cytometry may be useful in diagnosis of NMA, 17,23 but this method is not available on a commercial basis and currently is not commonly used. It is also difficult to perform in all cases due to the concern of invasive stress in neonates caused by collection of a large blood sample, and further studies of this method are needed.…”

Section: Discussionmentioning

confidence: 99%

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Management of neonatal cow’s milk allergy in high‐risk neonates

Miyazawa

Itahashi

Imai

2009

Pediatrics International

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management of neonatal cow’s milk allergy in high‐risk neonates

Miyazawa

Itahashi

Imai

2009

Pediatrics International

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“…Recently, it has been reported that infant cases of liver dysfunction complicated by cow's milk allergy improved after elimination of cow's milk formula [7,8]. Our two patients also developed liver dysfunction associated with cow's milk formula and had a positive cow's milk protein-specific LST, indicating sensitization of T cells to cow's milk proteins.…”

Section: Discussionmentioning

confidence: 56%

Characteristics and natural course of neonatal and infantile gastrointestinal milk allergy and the efficacy of oral immunotherapy

et al. 2012

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Summary The characteristics and natural course of gastrointestinal (GI) allergies, which mainly affect infants and young children, are not fully determined. We investigated the nature of neonatal and infantile GI allergies and the efficacy of slow oral immunotherapy in patients with persistent symptoms. We observed 12 patients (five boys, seven girls) aged at first presentation from 0 days to 8 months after birth. Detailed interviews, peripheral blood eosinophil counts, antigen‐specific IgE antibody levels, antigen‐specific lymphocyte stimulation tests (LSTs), stool occult blood eosinophil counts and skin tests were performed in combination with milk elimination tests. Five patients underwent an intestinal mucosal biopsy. Provocation testing was used to assess tolerance acquisition. The only clinical symptom in six patients was bloody stool, while vomiting, fever, poor weight gain or hepatic dysfunction developed in six patients. Milk‐specific LSTs were positive in 10 of 11 cases tested. Lower GI endoscopy showed large numbers of infiltrating eosinophils in four of five patients with an intestinal mucosal biopsy. Provocation tests to confirm tolerance acquisition were performed in three patients. Interestingly, one patient suffered IgE‐mediated GI anaphylaxis during the provocation test. One patient had a sustained high LST index, and elimination of dairy milk products was continued. At 4 years of age, she underwent an oral challenge test. On ingestion of 5 mL of milk, she exhibited fever, loose stool, poor appearance and increased white blood cell counts, which was considered a positive provocation test. Therefore, slow oral immunotherapy was started using 1/20 of the threshold dose, with fat intake at least four times per week. This was steadily increased by 20% over 2 weeks without inducing symptoms. The characteristics of neonatal and infantile GI allergies are diverse, and they generally remit spontaneously. However, patients who do not develop tolerance may be suitable choices for oral immunotherapy.

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“…Results of screening tests for congenital metabolic diseases at birth were also normal and she had thrived without any nutrient limitation, suggesting that causes other than metabolic diseases may have contributed to her fever and liver dysfunction, such as food allergies. Liver dysfunction due to cow’s milk protein allergy has been reported previously in Japan [ 13 - 15 ]. However, the reason for liver dysfunction and fever seen in case 2 cannot be explained by cow’s milk allergy, because both Ensure Liquid and Terumeal-mini contain cow’s milk-derived protein.…”

Section: Discussionmentioning

confidence: 99%

Enteral Nutrition Related Complications Relevant to Alteration of Formulas in Two Critically Ill Pediatric Patients

Akuzawa

Takeuchi

Tsukagoshi

et al. 2013

Gastroenterology Research

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The early institution of enteral nutrition is associated with beneficial outcomes and intestinal growth in pediatric patients. However, the number, frequency, and types of unfavorable events occurring with particular formulas are undefined. We experienced unexpected complications in two cases following a change in formula. One case diagnosed with myotubular myopathy experienced highly-increased gastric residuals and watery diarrhea leading to decreased calorie intake and weight loss. The second case with campomelic dysplasia suffered liver dysfunction and fever. In both cases, symptoms developed soon after of the change in formula and improved after resumption of the previous formula. Both cases had undergone tracheostomy and artificial ventilation, and had a history of feeding the same formula for an extended period of time. In chronic care patients such as ours, a change in formula may cause unexpected adverse events; therefore, caution is warranted.

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Infantile hepatic dysfunction improved by elimination of cows’ milk formulas

Cited by 12 publications

References 7 publications

Management of neonatal cow’s milk allergy in high‐risk neonates

Management of neonatal cow’s milk allergy in high‐risk neonates

Characteristics and natural course of neonatal and infantile gastrointestinal milk allergy and the efficacy of oral immunotherapy

Enteral Nutrition Related Complications Relevant to Alteration of Formulas in Two Critically Ill Pediatric Patients

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