Heiner's syndrome: Exploring beyond milk

Milk protein allergy, by non-IgE-mediated immune mechanisms, can present with nonspecific alveolar hemorrhage (Heiner's syndrome). We present the case of a 9-month-old infant with hemoptysis and diffuse pulmonary infiltrates who tested positive for milk, rice, and egg-white allergy on skin prick testing. The child responded to specific dietary elimination with reappearance of symptoms on accidental rice exposure. The present case highlights the need for exploring food allergies, other than milk, as a probable culprit in cases of unexplained hemoptysis.