Multiorgan Failure in a Malnourished Infant: Inappropriate Use of Goat Milk, Dilution, or Both?

Goat milk is gaining popularity in the United States as an alternative to cow and soy milk. The milk is presented as a healthier and less allergenic alternative, with casein and more MCT oil. The interest in goat milk has increased significantly with the recent formula shortage.

Trichobezoar: A Rare Cause of Protein-losing Enteropathy.

Protein-losing enteropathy (PLE) is caused by protein loss through the gastrointestinal tract which results in hypoalbuminemia. The most common causes of PLE in children include cow milk protein allergy, celiac disease, inflammatory bowel disease, hypertrophic gastritis, intestinal lymphangiectasia, and right-sided heart dysfunction. We present a case of a 12-year-old male with bilateral lower extremity edema, hypoalbuminemia, elevated stool alpha-1-antitrypsin, and microcytic anemia.

Natural History of Pediatric Cyclic Vomiting Syndrome: Progression to Dysautonomia.

Background: The clinical features of pediatric cyclic vomiting syndrome (CVS) often evolve over time. Many patients develop a constellation of chronic symptoms that suggest autonomic nervous system (ANS) dysfunction during adolescence. We aimed to determine the proportion of children with CVS who develop chronic rather than episodic symptoms consistent with ANS dysfunction.