Multiple food allergy presenting as Heiner syndrome in a Nigerian infant – Case report

Ikobah JM; Ikwuagwu E; Uhegbu K; Eshiet U; Ajake C; Ekanem E

doi:10.61386/imj.v17i3.530

Authors

Ikobah JM Paediatric Gastroenterology, Hepatology and Nutrition Unit, Department of Paediatrics, University of Calabar, Cross River State, Nigeria https://orcid.org/0000-0002-0400-2295
Ikwuagwu E Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
Uhegbu K Department of Paediatrics, University of Calabar, Calabar, Cross River State, Nigeria
Eshiet U Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
Ajake C Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
Ekanem E Department of Paediatrics, University of Calabar, Calabar, Cross River State, Nigeria

DOI:

https://doi.org/10.61386/imj.v17i3.530

Keywords:

Heiner syndrome, cow’s milk protein allergy, multiple food allergy, pneumonia, breast milk substitutes

Abstract

Background: Heiner syndrome (HS) is a rare non-IgE mediated hypersensitivity to cow’s milk or multiple food allergy characterized by chronic respiratory symptoms with chest X-ray infiltrates and resolution of these symptoms on dietary elimination of cow’s milk.

Case report: We present the case of a 9- month-old male with history of cough, fever, difficult breathing and wheezing who was initially managed for bronchopneumonia with no improvement of symptoms. With subsequent review, the history of allergy to cow’s milk, eggs, and crayfish with positive maternal history of food allergy was obtained. Elimination of offending foods led to symptom resolution and a re-challenge led to reappearance of symptoms.

Conclusion: This case report highlights the need for a high index of suspicion of HS in children with respiratory symptoms and a positive history of food allergy.