{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:27:28Z","timestamp":1789576048278,"version":"build-2803163510"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cow milk protein intolerance is a common gastrointestinal condition in the first year of life. It is mainly manifested as gastrointestinal and dermatology symptoms. It rarely presents as a respiratory manifestation only without other accompanying symptoms. We report a case of a 5-month-old Syrian boy who presented with a history of recurrent acute bronchitis symptoms (cough, wheezing, tachypnea) for 3\u00a0months with no significant personal or family history. Hematological and radiographic investigations were normal. The diagnosis of cow milk intolerance was confirmed by clinical, endoscopically, and histological findings. The child was placed on amino acid hydrolysate milk with restricted cow products. The child improved significantly, and chest symptoms improved within a week of the treatment. Despite the rarity of cow milk intolerance in children with only respiratory symptoms, it should be kept in mind when the patient has recurrent pulmonary infections that are not improving on appropriate therapy.<\/jats:p>","DOI":"10.1093\/omcr\/omad128","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T13:52:32Z","timestamp":1701265952000},"source":"Crossref","is-referenced-by-count":1,"title":["Recurrent pulmonary infections as the first manifestation of cow milk intolerance: a rare case report from Syria"],"prefix":"10.1093","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0814-5135","authenticated-orcid":false,"given":"Leen Jamel","family":"Doya","sequence":"first","affiliation":[{"name":"Tishreen University Hospital Department of Pediatrics, Faculty of Medicine, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayya","family":"Ismaeel","sequence":"additional","affiliation":[{"name":"Tishreen University Faculty of Pharmacy, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4740-1605","authenticated-orcid":false,"given":"Mohammad Fawaz","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Tishreen University Hospital Faculty of Medicine, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazan","family":"Ismaeel","sequence":"additional","affiliation":[{"name":"Tishreen University Hospital Faculty of Medicine, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazal","family":"Dib","sequence":"additional","affiliation":[{"name":"Tishreen University Hospital Department of Pediatrics, Faculty of Medicine, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuheir","family":"Alshehabi","sequence":"additional","affiliation":[{"name":"Tishreen University Hospital Department of Pathology, Professor of Pathology, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Tishreen University Hospital Department of Pediatrics, Professor of Gastroenterology and Hepatology, , Lattakia, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"2023112913522029000_ref1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MPG.0b013e31825c9482","article-title":"Diagnostic approach and management of cow\u2019s-milk protein allergy in infants and children: ESPGHAN GI committee practical guidelines","volume":"55","author":"Koletzko","year":"2012","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2023112913522029000_ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24953\/turkjped.2017.03.015","article-title":"Different presentations of cow's milk protein allergy during neonatal period","volume":"59","author":"Akta\u015f","year":"2017","journal-title":"Turk J Pediatr"},{"key":"2023112913522029000_ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40413-017-0173-0","article-title":"Lactose intolerance and gastrointestinal Cow's milk protein intolerance in infants and children\u2013common misconceptions revisited","volume":"10","author":"Heine","year":"2017","journal-title":"World Allergy Organ J"},{"key":"2023112913522029000_ref4","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1186\/s12887-019-1563-y","article-title":"Assessment of cows milk-related symptom scores in early identification of cows milk protein allergy in Chinese infants","volume":"19","author":"Zeng","year":"2019","journal-title":"BMC Pediatr"},{"key":"2023112913522029000_ref5","first-page":"153","article-title":"The spectrum of milk intolerance syndromes","volume":"12","author":"Brown","year":"2002","journal-title":"J Occup Environ Med"},{"key":"2023112913522029000_ref6","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.paed.2020.04.003","article-title":"Cow's milk protein allergy","volume":"30","author":"Dhesi","year":"2020","journal-title":"Paediatr Child Health"},{"key":"2023112913522029000_ref7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.arcped.2004.11.013","article-title":"Recurrent respiratory tract infections: how should we investigate and treat","volume":"12","author":"Cohen","year":"2005","journal-title":"Arch Pediatr"},{"key":"2023112913522029000_ref8","first-page":"127","article-title":"Le infezioni ricorrenti nel bambino: definizione ed approccio diagnostico","volume":"2","author":"Gruppo di Studio di Immunologia della Societ\u00e0 Italiana di Pediatria","year":"1988","journal-title":"Riv Immunol Allergol Ped"},{"key":"2023112913522029000_ref9","doi-asserted-by":"crossref","first-page":"92","DOI":"10.22516\/25007440.379","article-title":"Alergia a la prote\u00edna de leche de vaca. 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