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Diagnosing possible infantile cow's milk protein allergy in rural Africa, when history and physical examination are
Carsten Krüger1, Isaack Malleyeck
1Department of Paediatrics, St.-Franziskus-Hospital, Robert-Koch-Str. 55, D-59227 Ahlen, Germany. thea.carsten.krueger@web.de
Insights
Cow's milk protein allergy (CMPA) is often overlooked in developing nations. Early diagnosis and dietary changes can lead to rapid recovery in infants presenting with CMPA symptoms.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Global Health
Background:
- Cow's milk protein allergy (CMPA) is a prevalent condition in industrialized nations.
- CMPA is frequently underdiagnosed in developing countries due to its diverse clinical manifestations.
Observation:
- A case study of a Tanzanian infant presenting with blood-stained stools after consuming cow's milk.
- Initial misdiagnosis as amoebiasis highlights diagnostic challenges in resource-limited settings.
- Clinical improvement observed promptly after cow's milk elimination from the infant's diet.
Findings:
- The infant's symptoms resolved upon removal of cow's milk, strongly suggesting CMPA.
- Diagnostic limitations in developing countries can impede accurate identification of CMPA.
Implications:
- Increased clinical suspicion for CMPA is warranted in infants from developing countries, particularly those in agropastoralist communities.
- Early consideration of CMPA can improve infant health outcomes in resource-limited settings.
- Dietary management is a key intervention for managing CMPA in infants.
Introduction:
Cow's milk protein allergy is common in infants from industrialised countries, but is rarely considered in developing countries due to its variable clinical presentation.
Case Presentation:
We report on a Tanzanian male infant, who developed blood-stained stool when feeding fresh cow's milk at the age of three months. After an initial diagnosis of amoebiasis, possible cow's milk protein allergy was suspected. Further diagnostic work-up was not possible due to lack of resources. After elimination of cow's milk from the diet, the infant recovered soon.
Conclusion:
Cow's milk protein allergy should be considered more frequently in infants from developing countries, especially when they belong to agropastoralist tribes and are fed cow's milk early.
