Clinical Features of Heiner's Syndrome (Pulmonary Hemosiderosis Associated with Hypersensitivity to Cow's Milk)

 

Clinical features:

(1) infant being fed cow's milk

(2) failure to thrive

(3) gastrointestinal tract bleeding

(4) iron deficiency anemia

(5) recurrent episodes of pneumonia with pulmonary infiltrates and hemosiderosis

 

Laboratory findings:

(1) serum antibodies (precipitins) to cow milk proteins

(2) hemosiderin-laden macrophages in sputum

 

The diagnosis is supported if the findings resolve on elimination of cow's milk from the infant's diet.

 

Differential diagnosis:

(1) iron deficiency secondary to poor dietary intake ("milk baby", see 12.04)