HEINER SYNDROME AS A RARE FORM OF ALLERGY TO COW’S MILK PROTEINS DURING THE BABY’S FIRST YEAR OF LIFE

The problem of food allergy is now receiving considerable attention in paediatrics, due not only to its increasing prevalence but also to the difficulties of differential diagnosis of the disease. Cow's milk protein (CMP) is a leading food allergen in young children. The skin and gastrointestinal tract (GIT) most often become shock organs in case of CMP allergy, and the lungs are much less likely to be affected. One of the variants of lung tissue damage is Heiner syndrome – an extremely rare pathology caused by non-IgE-dependent hypersensitivity to CMP, which occurs mainly in infants and toddlers. This clinical case described 8-month-old baby suffering from recurrent broncho-obstructive syndrome resistant to standard therapy, and repeated pneumonia. Differential diagnosis was run with congenital pulmonary airway malformation, cystic fibrosis, primary immunodeficiencies, volume rendering of tracheobronchial tree, organic pathology of GIT, gastroesophageal reflux disease. All of the above mentioned conditions are excluded during laboratory and instrumental examination. Taking into account the burdened allergic anamnesis, familial predisposition to allergies, the presence of CMP in the child's diet, a rare form of CMP allergy with damage to lung tissue – Heiner syndrome was supposed. After correcting the child's nutrition and transferring him to feeding with an adapted milk formula based on highly hydrolyzed CMP, a positive dynamics of a pronounced degree was noted. Elimination diet is the main therapeutic approach for Heiner syndrome. The description of this clinical observation will help to increase the level of knowledge about rare forms of allergic pathology in children, timely diagnosis and improve the quality of medical care for such patients.