HEINER SYNDROME AND CORRELATION WITH FOOD ALLERGY - "case report"

PAULA POPOVICI¹Razvan Popovici^2*Maria-Alessandra Iuga¹Elena Tarca³DANA TEODORA ANTON PADURARU¹Bogdan A. Stana¹Lacramioara Butnariu⁴Radu Adrian Crisan Dabija⁵Catalina Lunca⁶Alina Mariela Murgu¹

• ¹Department of Pediatrics, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iași, Romania
• ²Department of Obstetrics and Gynaecology, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iași, Romania
• ³Universitatea de Medicina si Farmacie Grigore T Popa Iasi, Departamentul de Chirurgie Pediatrica, IASI, Romania
• ⁴Department of Genetics, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iași, Romania
• ⁵Department of Pneumology, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iași, Romania
• ⁶Spitalul Clinic de Urgenta pentru Copii Sfanta Maria Iasi, Iași, Romania

Heiner syndrome, although rare in pediatric practice, can cause cough, wheezing and only in rare cases hemoptysis. Heiner syndrome should be considered in any child presenting these respiratory symptoms and radiological evidence of alveolar infiltrates, especially when accompanied by signs of food allergy-most notably cow's milk protein allergy, although other foods seem to be involved. The use of probiotics should be evaluated with caution in these children. We report a case of a 1-year-and-6-month-old female patient who presented at the Pneumology Clinic with a one-day history of blood-tinged sputum. Although the patient had a known history of cow's milk protein allergy and well-controlled asthma, the occurrence of hemoptysis, even though in small quantities, raised concerns to the family. A second episode of hemoptysis appears when she received egg and probiotic. After correlating the patient's medical history with clinical, laboratory, and imaging findings, a diagnosis of Heiner syndrome was established. The patient received emergency treatment followed by bronchodilators, corticosteroid therapy, and restricted diet for cow's milk protein and egg. The patient's condition improved immediately after treatment and remained stable at the 5-month follow-up. The differential diagnosis with idiopathic pulmonary hemosiderosis must not be overlooked, due to its more severe clinical course and higher risk of complications.