Severe iron deficiency anemia and anasarca edema due to excessive cow’s milk intake

Özet

The authors describe a 13-month-old girl who presented with progressivelyworsening anasarca edema that developed over the last three weeks alongwith increasing fatigue. Over the last several months she was consumingprogressively increasing amounts of fresh cow’s milk. Laboratory examinationson admission showed severe microcytic and hypochromic anemia (hemoglobin3.8 g/dl) and hypoferritenemia indicative of iron deficiency, while urinalysesshowed no proteinuria. The child was transfused with 13ml/kg packed redblood cells and approximately 2g/kg intravenous albumin. On the second andfourth hospital days, she received 100 mg of iron sucrose intravenously thatshe tolerated well. Eight months after the described events, she is healthywith normal hemoglobin for age, while she has no laboratory evidence ofcow’s milk protein allergy. Pediatricians should be aware of the association ofsevere iron deficiency anemia (IDA) and anasarca edema, and should screeninfants in their practice for anemia at the age of 12 months or sooner, ifrisk factors are present.