The Consequence of Excessive Consumption of Cow's Milk: Protein-Losing Enteropathy with Anasarca in the Course of Iron Deficiency Anemia-Case Reports and a Literature Review

Abstract

Cow's milk is a key component of a child's diet. While the consumption of even trace amounts can result in allergy to its proteins and/or hypolactasia, excessive cow's milk consumption can result in numerous health complications, including iron deficiency, due to the diet being improperly balanced. Although the incidence of iron deficiency has declined, it remains the most widespread nutritional deficiency globally and the most common cause of anemia. One rare consequence of anemia caused by iron deficiency is protein-losing enteropathy; however, the mechanisms of its development are unclear. The following manuscript, based on a literature review, presents two rare cases of children, a 16-month-old boy and a 2.5-year-old girl, who developed severe microcytic anemia, enteropathy with hypoalbuminemia, and anasarca as a result of excessive cow's milk consumption. It highlights the possible relationship between excessive consumption of cow's milk in children and severe iron deficiency anemia with accompanying hypoalbuminemia; it may also result in serious clinical conditions, even in children that do not demonstrate food hypersensitivity.

Keywords: cow’s milk; cow’s milk protein allergy; diet; edema; health; iron deficiency; iron deficiency anemia; protein-losing enteropathy.

Figure 1

Consequences of excessive cow’s milk consumption.

Figure 2

Possible pathways of PLE development through the consumption of varying amounts of cow’s milk proteins (FPIP—food protein-induced proctocolitis, FPIES—food protein-induced enterocolitis syndrome, FPE—food protein-induced enteropathy, EGID—eosinophilic gastrointestinal disorders, IDA—iron deficiency anemia, PLE—protein-losing enteropathy).