Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 26:6:2324709618760078.
doi: 10.1177/2324709618760078. eCollection 2018 Jan-Dec.

Protein-Losing Enteropathy in the Setting of Severe Iron Deficiency Anemia

Jessica Lacy Yasuda  1 , Paul A Rufo  1
Affiliations

Protein-Losing Enteropathy in the Setting of Severe Iron Deficiency Anemia

Jessica Lacy Yasuda et al. J Investig Med High Impact Case Rep. .

Abstract

A 20-month-old boy presented with a 2-week history of pallor and progressive abdominal distention. Nutritional history revealed long-standing excessive cow milk intake. He was subsequently found to be profoundly iron deficient and hypoproteinemic, with an elevated fecal α-1-antitrypsin level and occult blood positive stool, consistent with protein-losing enteropathy. He was treated with cow milk restriction and oral iron supplements, which resulted in resolution of his edema and laboratory anomalies. While small numbers of previous case reports have described the potential association between excessive cow milk intake and severe iron deficiency and protein-losing enteropathy, this constellation of clinical symptoms is infrequently recognized in clinical practice. As iron deficiency is recognized as the most common nutritional deficiency in the United States, it is important to keep excessive cow milk intake in mind when evaluating young children presenting with severe iron deficiency and protein-losing enteropathy.

Keywords: PLE; anasarca; anemia; iron deficiency; protein-losing enteropathy; whole cow milk.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Levitt DG, Levitt MD. Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states. Clin Exp Gastroenterol. 2017;10:147-168. - PMC - PubMed
    1. Schubert WK, Lahey ME. Copper and protein depletion complicating hypoferric anemia of infancy. Pediatrics. 1959;24:710-733. - PubMed
    1. Naiman JL, Oski FA, Diamond LK, Vawter GF, Shwachman H. The gastrointestinal effects of iron deficiency anemia. Pediatrics. 1964;33:83-99. - PubMed
    1. Wilson JF, Heiner DC, Lahey ME. Milk-induced gastrointestinal bleeding in infants with hypochromic microcytic anemia. JAMA. 1964;189:568-572. - PubMed
    1. Hamrick HJ. Whole cow’s milk, iron deficiency anemia, and hypoproteinemia: an old problem revisited. Arch Pediatr Adolesc Med. 1994;148:1351-1352. - PubMed

LinkOut - more resources