JPGN Reports · 3 authors, 1 centre
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A retrospective case series of 7 toddlers with excessive cow milk intake who presented with edema, iron deficiency anemia, and protein-losing enteropathy found that cow milk restriction and oral iron supplementation led to resolution of edema and improvement in anemia in all patients at follow-up.
This retrospective case series reviewed 7 toddlers (median age 20 months; range 14–27 months) treated at a single tertiary care institution between November 2016 and January 2019. All patients presented with edema, abdominal distension, and pallor in the context of excessive cow milk intake (>=24 oz/d) and had laboratory evidence of iron deficiency anemia and hypoalbuminemia with elevated stool alpha-1 antitrypsin consistent with protein-losing enteropathy. All patients received cow milk restriction and oral iron supplementation, while 4 also received parenteral interventions. The median changes in hemoglobin and albumin pre- and post-treatment were +5.4 g/dL and +1.8 g/dL, respectively. At follow-up of about 3 months, all 7 patients had resolution of edema, and 6 of 7 had hemoglobin levels >11 g/dL. Endoscopy and colonoscopy in 2 patients showed normal results. The authors note the nonuniform diagnostic and treatment approaches and the need for prospective data.
