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Protein-losing enteropathy associated with egg allergy in a 5-month-old boy
1Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
Journal of Investigational Allergology & Clinical Immunology
|March 26, 2008
Summary
Severe protein-losing enteropathy (PLE) in an infant was caused by an egg allergy transmitted through breast milk. Eliminating egg from the mother's diet resolved the infant's severe symptoms and confirmed the diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Clinical Nutrition
Background:
- Protein-losing enteropathy (PLE) is a condition characterized by excessive loss of plasma proteins into the gastrointestinal tract, leading to hypoalbuminemia.
- Infantile PLE can stem from various underlying causes, presenting diagnostic challenges.
- Allergic reactions are increasingly recognized as potential triggers for gastrointestinal protein loss.
Observation:
- A 5-month-old exclusively breastfed infant presented with severe PLE, including hypogammaglobulinemia, hypocalcemia, and hypomagnesemia.
- The infant experienced hypocalcemic convulsions, indicating significant electrolyte disturbances.
- Diagnostic confirmation included elevated fecal alpha1-antitrypsin clearance and positive protein-losing scintigraphy.
Findings:
- The infant's PLE was definitively linked to an egg allergy, with symptoms triggered by egg proteins transferred via maternal breast milk.
- Maternal dietary elimination of eggs led to rapid clinical improvement in the infant.
- Reintroduction of egg (maternal challenge) provoked a recurrence of PLE symptoms and elevated fecal alpha1-antitrypsin clearance.
Implications:
- This case highlights the critical role of maternal diet in exclusively breastfed infants with suspected food allergies.
- Egg allergy should be considered in the differential diagnosis of infantile PLE, particularly when other causes are not apparent.
- Early diagnosis and targeted dietary management can effectively resolve PLE induced by food allergies, preventing severe complications.
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