Tracy Michaela S, Yasuda Jessica L, Rufo Paul A
Department of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA.
JPGN Rep. 2020 Aug 21;1(2):e009. doi: 10.1097/PG9.0000000000000009. eCollection 2020 Nov.
Protein-losing enteropathy (PLE) in the setting of severe iron deficiency anemia (IDA) and excessive cow milk intake is an uncommonly recognized phenomenon. Here, we describe a series of 7 toddlers who presented for evaluation of edema in the setting of excessive cow milk intake between November 2016 and January 2019. Laboratory studies in each patient were consistent with IDA and hypoalbuminemia with evidence of PLE. Diagnostic evaluation and treatment of each patient differed, although all were instructed to restrict cow milk and provided with oral iron supplementation. The edema had resolved, and the IDA had improved in all 7 patients by the time of their follow-up outpatient appointments. Iron deficiency and PLE should be considered in patients who present with anasarca.
在严重缺铁性贫血（IDA）和过量摄入牛奶的情况下发生的蛋白丢失性肠病（PLE）是一种鲜为人知的现象。在此，我们描述了2016年11月至2019年1月期间因过量摄入牛奶出现水肿前来评估的7名幼儿。每名患者的实验室检查结果均符合IDA和低蛋白血症，并伴有PLE的证据。尽管所有患者均被指示限制牛奶摄入并给予口服铁补充剂，但每名患者的诊断评估和治疗方法有所不同。在进行门诊随访时，所有7名患者的水肿均已消退，IDA也有所改善。对于出现全身性水肿的患者，应考虑缺铁和PLE。
