Severe upper gastrointestinal hemorrhage due to milk protein allergy: A case report

Table 1 Cases of cow’s milk protein allergy with upper gastrointestinal hemorrhage

Case	Onset age	Sex	Clinical manifestation; growth status	Laboratory examination	Endoscopy	Treatment	Follow-up time outcomes
Case 1[21]	3-month	Boy	Bloody vomiting eczema; weight 7.035 kg, height 68 cm	Hb: 96 g/L; WBC: 7.8 × 1012/L; 3% eosinophils	The gastric mucosa was diffusely friable and erythematous, with multiple incomplete erosions	Trial feeding of cow’s-milk infant formula	Improved
Case 2[22]	Newborn (1-day)	Boy	Bloody gastric aspirates, bloody stools, anemia	Hb 139 g/L; WBC: 25 × 1012/L; 6% eosinophils; IgE (-)	Erythema in the stomach	Amino acid milk formula	11weeks; improved
Case 3[23]	3-month	Boy	Bloody vomiting, bloody stool, eczema, fever, refuse feeding, anemia; weight loss	Hb: 57 g/L	-	Homogenized milk; mullsoy formula; soybean formula	22 months; improved
Case 4[24]	Premature infant	Girl	Coffee colored mucoid gastric content, eczema, anemia; low birth weight infants	Hb: 99 g/L; IGE (+)	-	Amino; acid milk formula	2 months; improved
Case 5[25]	8-months	Boy	Vomiting; of fresh blood, melena, diarrhea, wheezy, anemia; weight 8.5 kg, length 72 cm	Hb: 78 g/L; IGE (+)	Mild diffuse gastritis, erythematous, erosive and hemorrhagic mucosa of duodenum	Dietary restriction	Improved
Case 6[26]	24-months	Boy	Vomiting, hematemesis, regurgitate, irritability, anemia; weight loss	Hb: 102 g/L; WBC: 15.6 × 1012/L; 3% eosinophils	Hemorrhagic erosive pangastritis, 24.1 eosinophils/HPF HP negative	Dietary restriction, soya based; formula	2 years; improved
Case 7[26]	24-months	Girl	Vomiting, hematemesis, diarrhea, anemia; weight loss	-	Esophagitis, erosive, gastritis on the cardia and anterior corpus wall and duodenitis	Dietary restriction, semi-elemental formula	2 years; improved

Hb: Hemoglobin; WBC: White blood cell; IgE: Immunoglobulin E; HPF: High power field; HP: Helicobacter pylori.