Camel milk in children with cow milk allergy: Is it time for more investigations and less skepticism?

s / Digestive and Liver Disease 47S (2015) e237–e276 e265 neous rash, night sweating and systemic lymphadenitis. Hodgkin lymphomawas diagnosed at pediatric hematology and chemotherapy and radiotherapy were administered. She was admitted to our GI surgery practice because of refractory to iron therapy anaemia (haemoglobin 11.4 g/dl nv.12.1–15.2; serum iron 7.8 mol/L nv.9–21.5; ferritin1107 g/L nv.15–150; transferrin 2.28g/L nv.2.5–3.8). Workup: • EmA-IgA positive (nv.negative); Ab-anti-tTg-IgA>100UA/ml (nv. 100UA/ml (nv.<10UA/ml); IgA 1.47g/L (nv.0.34–3.48g/L). • The genetic typing showed the DQA1*05/DQB1*02 alleles presence coding HLA-DQ2. Therapy: Coeliac disease was diagnosed, gluten free diet was administered and quarterly checkups were planned. Results: At first checkup: clinical improvement, increase in haemoglobin (12.2 g/dl) and decrease of ab-anti-t-Tg-IgA (28.2UA/ml) were observed. Conclusions: We can’t rule out that Hodgkin lymphoma have been triggeredby infectiousmononucleosis but this case could confirm the recent studies demonstrating how the risk to developing lymphomas increased in undiagnosed coeliac patients. Take home message: Screening for coeliac disease should always be done not only in pediatric hematologic patients with iron deficiency anaemia but also in the ones that develop lymphoproliferative disorders. http://dx.doi.org/10.1016/j.dld.2015.07.124