Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow’s milk protein allergy

ObjectiveTo evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow’s milk protein allergy (CMPA).MethodsA total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5).ResultsFrom baseline to visit 2 and visit 3, WFA z-scores (from −0.60 ± 1.13 to −0.54 ± 1.09 at visit 2, and to −0.44 ± 1.05 at visit 3, p < 0.001) and WFL z-scores (from −0.80 ± 1.30 to −0.71 ± 1.22 at visit 2, and to −0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%).ConclusionsIn conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction

Life-threatening Anemia with Hemolysis, Thrombocytopenia and Brain Atrophy due to Vitamin B12 Deficiency

Megaloblastic anemia due to vitamin B12 deficiency is rare in infancy. It usually occurs in exclusively breast-fed infants born to vitamin B12-deficient mothers. We report a one-year-old female infant with initial diagnosis of leukemia who was found severely vitamin B12-deficient secondary to maternal deficiency. She had marked neurodevelopmental retardation, and presented with life-threatening anemia, findings of hemolysis, thrombocytopenia and cerebral atrophy on magnetic resonance imaging. [Cukurova Med J 2014; 39(4.000): 900-904

Anaphylaxis: Turkish National Guideline 2018

Anaphylaxis is an acute and potentially fatal systemic reaction that sould be recognized and managed by all helthcare professionals. This is the first national guideline of Turkish National Society of Allergy and Clinical Immunology on diagnosis and management of anaphylaxis. The guideline is prepared by Anaphylaxis Interest Group with the incorporation of 20 allergy/immunology specialists and the epidemiology, etiology, pathophysiology, symptoms and signs, diagnosis/differentials, and acute and long-term management of anaphylaxis are reviewed in detail