Jiang HH, Tang Q, Huang L, Yun X, Shan QW, Chen XQ. Severe upper gastrointestinal hemorrhage due to milk protein allergy: A case report. World J Clin Cases 2025; 13(14): 104039 [DOI: 10.12998/wjcc.v13.i14.104039]
Corresponding Author of This Article
Xiu-Qi Chen, Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. chenxiuqi@gxmu.edu.cn
Research Domain of This Article
Allergy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Huan-Huan Jiang, Qing Tang, Li Huang, Xiang Yun, Qing-Wen Shan, Xiu-Qi Chen, Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Jiang HH contributed to data collection, statistically analyzed, and drafting of the paper; Tang Q, Huang L, Yun X, and Shan QW performed data collection design and revision of the paper; Chen XQ contributed the conception and design of study and revised the final paper; and all authors approved the final submitted manuscript.
Supported by the Excellent Medical Talents Training Program of the First Affiliated Hospital of Guangxi Medical University, Difficult and Critical illness Center, Pediatric Clinical Medical Research Center of Guangxi, No. Gui Ke AD22035219; and the Key Laboratory of Children’s Disease Research in Guangxi’s Colleges and Universities, Education Department of Guangxi Zhuang Autonomous Region.
Informed consent statement: The verbal informed consent was obtained from all the parents or guardians of the patients involved.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiu-Qi Chen, Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. chenxiuqi@gxmu.edu.cn
Received: December 8, 2024 Revised: December 21, 2024 Accepted: January 7, 2025 Published online: May 16, 2025 Processing time: 38 Days and 13 Hours
Abstract
BACKGROUND
Upper gastrointestinal hemorrhage is a life-threatening manifestation of cow’s milk protein allergy (CMPA). We analyze the clinical characteristics of a case of milk protein allergy manifested as severe upper gastrointestinal hemorrhage.
CASE SUMMARY
The hospital admitted a 2-month-old male infant due to “melena for 6 days, hematemesis twice”. The main symptom was melena, initially occurring once or twice per day, then gradually increasing to five or six times per day at their peak. During the course of the illness, the infant vomited blood, but there were no reports of vomiting, fever, pale complexion, dyspnea, wheezing, or difficulty breathing. Laboratory tests showed hemoglobin level of 87 g/L, platelet count of 349 × 109/L, and eosinophil percentage of 0.031. Coagulation studies were normal. After avoiding certain foods and feeding with an amino acid formula for 2 weeks, a repeat gastroscopy revealed less bleeding. After six weeks, a positive oral food challenge test confirmed a severe CMPA. At the 4-month follow-up, there was no gastrointestinal bleeding, and the infant was growing and developing well.
CONCLUSION
The manifestations of milk protein allergy are diverse and nonspecific, with gastrointestinal bleeding being less common, especially in infants. When infants present with unexplained massive hematemesis, it’s critical to investigate the possibility of CMPA.
Core Tip: Milk protein allergy is the most common food allergy reaction in infants and children under three years old, with diverse and non-specific clinical manifestations. Severe clinical symptoms such as gastrointestinal bleeding can be life-threatening, requiring doctors to be vigilant. This study, by reporting a case of severe milk protein allergy in children, will play a warning role in future clinical application.
