Heiner Syndrome and Milk Hypersensitivity: An Updated Overview on the Current Evidence.

Stefania Arasi, Carla Mastrorilli, Luca Pecoraro, Mattia Giovannini, Francesca Mori, Simona Barni, Lucia Caminiti, Riccardo Castagnoli, Lucia Liotti, Francesca Saretta, Gian Luigi Marseglia, Elio Novembre

Journal: Nutrients 2021;13(5):1710

PMID: 34070007

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Abstract

Infants affected by Heiner syndrome (HS) display chronic upper or lower respiratory tract infections, including otitis media or pneumonia. Clinically, gastrointestinal signs and symptoms, anemia, recurrent fever and failure to thrive can be also present. Chest X-rays can show patchy infiltrates miming pneumonia. Clinical manifestations usually disappear after a milk-free diet. The pathogenetic mechanism underlying HS remains unexplained, but the formation of immune complexes and the cell-mediated reaction have been proposed. Patients usually outgrow this hypersensitivity within a few years. The aim of this review is to provide an updated overview on the current evidence on HS in children, with a critical approach on the still undefined points of this interesting disease. Finally, we propose the first structured diagnostic approach for HS.

Address: Translational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.; Pediatric Unit and Emergency, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70126 Bari, Italy.; Department of Medicine, University of Verona, 37129 Verona, Italy.; Pediatric Unit, ASST Mantua, 46100 Mantua, Italy.; Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, 50139 Florence, Italy.; Department of Human Pathology in Adult and Development Age "Gaetano Barresi", Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, 98158 Messina, Italy.; Department of Pediatrics, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy.; Department of Pediatrics, AOU Ospedali Riuniti Ancona, Presidio Ospedaliero di Alta Specializzazione "G. Salesi", 60126 Ancona, Italy.; Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy.; Department of Health Science, University of Florence, 70126 Florence, Italy.

DOI: 10.3390/nu13051710

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MeSH Terms: Female, Humans, Infant, Infant, Newborn, Male, Milk Hypersensitivity, Milk Proteins, Respiratory Hypersensitivity, Syndrome