Cow's milk protein allergy with protein-losing enteropathy under the scope

Article Article scientifique Article Cow's milk protein allergy with protein-losing enteropathy under the scope eng 2025-07-16 2025-11 author Thorens Morgane 0009-0002-0432-5307 Pediatric Gastroenterology, Hepatology and Nutrition Unit, Geneva University Hospitals, Department of Pediatrics, Gynecology, and Obstetrics University of Geneva Geneva Switzerland. 836542 author Blanchard Rohner Géraldine Pediatric Immunology and Vaccinology Unit Geneva University Hospitals Geneva Switzerland. 518713 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Ramadan Salim Pediatric Allergy Unit, Division of Pediatric Subspecialities, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and Faculty of Medicine University of Geneva Geneva Switzerland. 645839 author Caubet Jean-Christoph Roger J-P Pediatric Allergy Unit, Division of Pediatric Subspecialities, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and Faculty of Medicine University of Geneva Geneva Switzerland. 106429 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Petit Laëtitia Marie Pediatric Gastroenterology, Hepatology and Nutrition Unit, Geneva University Hospitals, Department of Pediatrics, Gynecology, and Obstetrics University of Geneva Geneva Switzerland. 810470 author Mclin Valérie Anne Pediatric Gastroenterology, Hepatology and Nutrition Unit, Geneva University Hospitals, Department of Pediatrics, Gynecology, and Obstetrics University of Geneva Geneva Switzerland. 799651 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Rougemont-Pidoux Anne-Laure Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals and Faculty of Medicine University of Geneva Geneva Switzerland. 29140 Département de pathologie et immunologie (PATIM) 342-350 10.1002/jpr3.70026 41245010 2691-171X PMC12611621 https://onlinelibrary.wiley.com/doi/10.1002/jpr3.70026 Objectives: Cow's milk protein allergy (CMPA) is very frequent in infants. Presentation is variable, and symptoms fluctuate in intensity. Diagnosis can be challenging as it is mostly clinical. In severe cases, patients can present with anasarca secondary to protein-losing enteropathy (PLE). The exact mechanism underlying PLE is incompletely understood. Here we report four cases of severe PLE caused by CMPA warranting endoscopic workup in whom histological expression was characterized by variable features along the gastrointestinal (GI) tract. Methods: We report four cases of severe CMPA with PLE requiring extensive workup including endoscopy to exclude immune deficiency or congenital enteropathy. The different histological expressions along the GI tract are presented. Results: Histology ranged from the expected eosinophilia, observed in all cases, to severe mucosal atrophy with subtotal loss of colonic glands. Correlation between endoscopy and histology was poor. Conclusion: CMPA can affect any segment of the GI tract and the intensity of the histological findings varies among patients and localizations. Food protein allergy should be considered in infants and children with hypoalbuminemia. Endoscopy and histology correlation Eosinophilia Hypoalbuminemia Dewey 616.07 Dewey 618 137 Département de pathologie et immunologie 21F 58 Département de pédiatrie, gynécologie et obstétrique 223 false 559 Pathologies hépatiques congénitales et acquises de l'enfant 900 JPGN reports 6 4 182a362f-98b1-498e-bcca-b0c0e33e76ec Article (Published version) Public Article_scientifique_from_europePmc.pdf 2021161 application/pdf CC BY-NC-ND-4.0 cd9019f34994b15b8e07f32e4c0a63dd30e0076deb03aab32c06ad86b699547d fdd4aa12-cbd3-40c2-b3aa-d6fd7bfb5ba7 Supplemental data Public jpr370026-sup-0001-supplfig1.tif 4919026 image/tiff 5e28ed23b38616c5ed6690c9bae74c406641e62951f978a2b129c31a221e4dad 17179610-22b8-46be-bbce-16288e1efcec Supplemental data Public jpr370026-sup-0002-supplfig2.tif 4919026 image/tiff c1c1e00beb86e91603a51940c488211f3422cab843f8db4c240fa55f3fde4584 241d528e-da31-4f7d-9baa-35cf49d686b5 Supplemental data Public jpr370026-sup-0003-suppltable1w.docx 15214 application/vnd.openxmlformats-officedocument.wordprocessingml.document e02757a17f9ed01b6e2139f9d11b747be28d38eefd3631deccbf98812d7e40fa openAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Cow's milk protein allergy with protein-losing enteropathy under the scope	JPGN reports			2025	10	35

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Thorens, Morgane