A Case of Transposition of the Great Arteries that Led to the Development of Non-IgE-Mediated Gastrointestinal Food Allergy after a Neonatal Necrotizing Enterocolitis Complication

Abstract

Neonatal necrotizing enterocolitis (NEC) is a serious complication associated with congenital heart disease (CHD). Non-IgE-mediated gastrointestinal food allergy (non-IgE-GI-FA) in neonates and infants manifests as digestive symptoms, including emesis, diarrhea, melena, and abdominal distension, with occasional intestinal perforation and NEC. Previous studies showed the relationship between CHD and non-IgE-GI-FA, which suggests that a decrease in intestinal blood ow can be a risk factor of non-IgE-GI-FA in neonates and infants with CHD. We report the case of a neonate with transposition of the great arteries who developed NEC before an arterial switch operation (ASO) and non-IgE-GI-FA a er the operation. e patient presented with bloody stools a er the start of formula feeding and was diagnosed with NEC on the basis of abdominal radiography ndings. A er recovery from NEC, the patient underwent ASO. However, the patient presented with abdominal distension a er formula feeding was restarted and was diagnosed with non-IgE-GI-FA on the basis of the ndings of eosinophilia and positivity in an allergen-speci c lymphocyte stimulation test. is demonstrates that postoperative digestive symptoms impose the possibility of non-IgE-GI-FA in neonates with CHD, especially in those with an NEC complication. erefore, we infer that if gastrointestinal complications occur in patients with severe CHD, the possibility of non-IgE-GI-FA should be considered.