Food protein induced enteropathy in a 1-month-old child presenting chronic diarrhea and severe acute malnutrition: A case report

Abstract

Abstract
Introduction: Cow’s milk protein allergy (CMPA) is the most common food allergy in young children, and can result in various manifestations that are difficult to diagnose.
Objective: To describe the rare case of a 1-month-old male infant with food protein-induced enteropathy (FPE).
Case presentation: A retrospective descriptive study collected data from the medical records of patients admitted to Burapha University Hospital throughout August, 2020. A 1-month-old male infant with food protein-induced enteropathy (FPE) was presented with chronic diarrhea. A fecal test found fat globules, electrolyte disturbance, hyponatremia, metabolic acidosis and
severe acute malnutrition, after a few days on a formula milk intake. Refeeding syndrome occurred in the third day of hospitalization, after an increase in elemental formula. Severe acute malnutrition was thought to be the primary cause of the liver parenchymal disease, cholestatic jaundice and elevated liver enzymes. Ultimately, the patient’s symptoms stabilized with the introduction of an elemental formula, confirming the diagnosis of severe CMPA. By 19 months, he was thriving on a regular diet, which included a whole milk formula. He had normal growth and no symptoms of diarrhea.
Conclusion: On rare occasions, cow’s milk allergy presents itself with chronic diarrhea, electrolyte disturbance and severe acute malnutrition. When diagnosis is delayed, this allergy may impair growth and quality of life, and may even be life-threatening.