The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 3
Different presentations of cow`s milk protein allergy during neonatal period
Selma Aktaş 1 ,Ebru Ergenekon 2 ,Sezin Ünal 3 ,Canan Türkyılmaz 2 ,İbrahim Murat Hirfanoğlu 2 ,Yıldız Atalay 2
1 Division of Neonatology, Department of Pediatrics, Gaziosmanpasa Taksim Research and Training Hospital, İstanbul, Turkey
2 Division of Neonatology, Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
3 Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
DOI : 10.24953/turkjped.2017.03.015 Aktaş S, Ergenekon E, Ünal S, Türkyılmaz C, Hirfanoğlu İM, Atalay Y. Different presentations of Cow`s milk protein allergy during neonatal period. Turk J Pediatr 2017; 59: 322-328.

Cow`s milk protein allergy (CMPA) is the most common cause of allergy occurring in the first year of life due to infant formula or breast-milk of mothers who are drinking cow`s milk or eating cow`s milk products. Most children with allergic colitis are symptomatic in the first months, usually by 4 weeks. There are rare cases whom were sensitized prenatally and demonstrated symptoms in the first week, even in the first 2 days of life. The most common clinical sign of CMPA is bloody stool in a well-appearing infant. Gross bloody stool or fecal occult blood are also the common signs of necrotizing enterocolitis (NEC), especially in preterm infants with systemic instability. The treatment options are totally different so the clinician has to be very careful evaluating the patient. We report 5 preterm cases of CMPA, two of whom were siblings. Two of them presented with massive bloody stools and 3 of them presented with abdominal distension and fecal occult blood all of which were initially considered as NEC. Literature review of 20 cases with similar history is summarized as well. Keywords : cow`s milk protein allergy, neonate, prematurity, differential diagnosis

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