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A male preterm infant with cow's milk allergy to human milk fortifier showing only severe respiratory symptoms.
Fukushima J Med Sci. 2019 Aug 30; 65(2):50-54.FJ

Abstract

We report a male infant with a birthweight of 1,400 g at 29 weeks 2 days gestation diagnosed as having cow's milk allergy (CMA) due to human milk fortifier, who developed severe respiratory symptoms. The infant had no gastrointestinal symptoms; rather, the initial symptoms were apnea attacks and wheezing with a prolonged expiratory phase that progressed to severe ventilatory insufficiency requiring mechanical ventilation. Aggravation of his general condition, which appeared to be due to sepsis, was improved by temporary starvation and respiratory care, but he relapsed on the resumption of enteral feeding of his mother's milk with a human milk fortifier. As a result, this event was interpreted as a positive oral food challenge test. The infant resumed complete breastfeeding without the fortifier and has not relapsed since. Examination of his serial cytokine profiles from residual serum revealed that although interleukin-5 was not increased, interferon (IFN)-γ was increased, suggesting some relation between the time course of IFN-γ and the infant's eosinophil count. These findings may indicate that the involvement of IFN-γ is one cause of the onset of this disease.

Authors+Show Affiliations

Department of Neonatology, Japanese Red Cross Musashino Hospital.Department of Neonatology, Japanese Red Cross Musashino Hospital.Department of Pediatric and Neonatal Intensive Care, The University of Tokyo Hospital.Department of Neonatology, Japanese Red Cross Musashino Hospital.Department of Neonatology, Japanese Red Cross Musashino Hospital.Department of Neonatology, Japanese Red Cross Musashino Hospital.Department of Pediatric and Neonatal Intensive Care, The University of Tokyo Hospital.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31327804

Citation

Nakamura, Toshihiko, et al. "A Male Preterm Infant With Cow's Milk Allergy to Human Milk Fortifier Showing Only Severe Respiratory Symptoms." Fukushima Journal of Medical Science, vol. 65, no. 2, 2019, pp. 50-54.
Nakamura T, Hatanaka D, Kashima K, et al. A male preterm infant with cow's milk allergy to human milk fortifier showing only severe respiratory symptoms. Fukushima J Med Sci. 2019;65(2):50-54.
Nakamura, T., Hatanaka, D., Kashima, K., Kusakari, M., Takahashi, H., Kamohara, T., & Takahashi, N. (2019). A male preterm infant with cow's milk allergy to human milk fortifier showing only severe respiratory symptoms. Fukushima Journal of Medical Science, 65(2), 50-54. https://doi.org/10.5387/fms.2019-10
Nakamura T, et al. A Male Preterm Infant With Cow's Milk Allergy to Human Milk Fortifier Showing Only Severe Respiratory Symptoms. Fukushima J Med Sci. 2019 Aug 30;65(2):50-54. PubMed PMID: 31327804.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A male preterm infant with cow's milk allergy to human milk fortifier showing only severe respiratory symptoms. AU - Nakamura,Toshihiko, AU - Hatanaka,Daisuke, AU - Kashima,Kohei, AU - Kusakari,Michiko, AU - Takahashi,Hidehiro, AU - Kamohara,Takashi, AU - Takahashi,Naoto, Y1 - 2019/07/20/ PY - 2019/7/23/pubmed PY - 2020/2/15/medline PY - 2019/7/23/entrez KW - Cow’s milk allergy KW - Human milk fortifier KW - Interferon gamma KW - Preterm KW - Respiratory symptoms SP - 50 EP - 54 JF - Fukushima journal of medical science JO - Fukushima J Med Sci VL - 65 IS - 2 N2 - We report a male infant with a birthweight of 1,400 g at 29 weeks 2 days gestation diagnosed as having cow's milk allergy (CMA) due to human milk fortifier, who developed severe respiratory symptoms. The infant had no gastrointestinal symptoms; rather, the initial symptoms were apnea attacks and wheezing with a prolonged expiratory phase that progressed to severe ventilatory insufficiency requiring mechanical ventilation. Aggravation of his general condition, which appeared to be due to sepsis, was improved by temporary starvation and respiratory care, but he relapsed on the resumption of enteral feeding of his mother's milk with a human milk fortifier. As a result, this event was interpreted as a positive oral food challenge test. The infant resumed complete breastfeeding without the fortifier and has not relapsed since. Examination of his serial cytokine profiles from residual serum revealed that although interleukin-5 was not increased, interferon (IFN)-γ was increased, suggesting some relation between the time course of IFN-γ and the infant's eosinophil count. These findings may indicate that the involvement of IFN-γ is one cause of the onset of this disease. SN - 2185-4610 UR - https://www.unboundmedicine.com/medline/citation/31327804/A_male_preterm_infant_with_cow's_milk_allergy_to_human_milk_fortifier_showing_only_severe_respiratory_symptoms L2 - https://dx.doi.org/10.5387/fms.2019-10 DB - PRIME DP - Unbound Medicine ER -