Two cases of non-IgE-mediated gastrointestinal food allergies that appeared to show a change in clinical subtypes depending on the degree of milk protein degradation

Abstract

We report two cases of non-IgE-mediated gastrointestinal food allergies that appeared to show changes in clinical subtypes depending on the degree of milk protein degradation.

Case 1: A 24-day-old formula-fed neonate showed symptoms suspected cluster 1 and these improved with an extensively hydrolyzed formula. However, at 2 months, she developed gross blood in the stool and anemia and appeared to have a low nutritional status, which were resolved after switching to an amino acid-based formula. We performed oral food challenges from 9 months old and confirmed remission.

Case 2: A 7-day-old neonate showed poor weight gain on a standard infant formula and was switched to an extensively hydrolyzed formula from day 15. Although her weight gain improved, she developed gross blood in the stool and anemia and appeared to have a low nutritional status at 2 months. These symptoms were resolved after switching to an amino acid-based formula. We performed oral food challenges from 9 months old and confirmed remission.

Conclusion: Clinical subtypes of non-IgE-mediated gastrointestinal food allergies may appear to change depending on milk protein antigenicity. Careful follow-up of these patients is required.