Diagnosing possible infantile cow's milk protein allergy in rural Africa, when history and physical examination are the only tools: a case report

Table 1 Common symptoms of cow's milk protein allergy (CMPA) in infants (modified after Vandenplas et al

Organ system	Symptoms in severe CMPA	Symptoms in mild to moderate CMPA
Gastrointestinal	Failure to thrive due to chronic diarrhoea	Frequent regurgitation
	Refusal to feed	Vomiting
	Vomiting	Diarrhoea
	Iron deficiency anaemia due to occult/macroscopic blood loss	Constipation (with/without perianal rash)
		Blood in stool
	Endoscopically/histologically confirmed enteropathy or severe colitis	Iron deficiency anaemia
Respiratory (without signs of infection)	Acute laryngoedema	Runny nose, otitis media
	Bronchial obstruction with difficulty in breathing	Chronic cough
		Wheezing
Skin	Exudative or severe atopic dermatitis	Atopic dermatitis
	- with hypoalbuminaemia	Swelling of lips or eye lids (angio-oedema)
	- with failure to thrive	Urticaria unrelated to infection, drugs or other causes
	- with iron deficiency anaemia
General	Anaphylaxis	Persistent colic or distress at least 3 days per week for more than 3 weeks