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Cow’s milk protein-induced gastritis: a common cause of hematemesis in infants.
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  • Abdelghani Yagoubi,
  • Abdelhalim Haroune,
  • Djamila Raissi-Kerboua,
  • Leila Smati
Abdelghani Yagoubi
Centre Algérois de Pédiatrie

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Abdelhalim Haroune
Private Pathology Laboratory Center
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Djamila Raissi-Kerboua
Private Pathology Laboratory Center
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Leila Smati
Bologhine Ibn Ziri Public Hospital
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Abstract

Introduction: Gastrointestinal signs and symptoms are frequent in cow’s milk (CM) protein allergy; however, gastritis is not usually mentioned among these manifestations. Here we present a series of infants with CM-induced gastritis. Methods: We analyzed retrospectively data of infants who presented at our center with hematemesis and endoscopic gastritis with clinical improvement after exclusion of CM protein. Results: Thirty-one infants (17 females) were included in this study. The mean age was 5.8 months. The mean time from CM introduction to hematemesis was 3.5 months. A family history of allergies was found in 67.7% of cases. The initial symptoms included hematemesis (100%), vomiting (67.7%) and melena (22.6%). Gastritis was noted in all the infants (erosive in 58.1%). Gastric biopsies were performed in only 10/31 patients and eosinophilic infiltration was observed in all patients. CM-specific IgE tests performed on 20/31 infants were negative in all cases. All infants were asymptomatic after exclusion of CM. When performed between 3 and 4 weeks after the exclusion of CM, oral food challenge was positive in 17/17. Tolerance to CM was achieved after 6 to 9 months of CM exclusion in all 31 infants. Conclusion: Our findings emphasize the importance of recognizing hematemesis as a warning sign for CM protein induced gastritis, a non-IgE mediated form of CM allergy.