scholarly journals Primary Immunodeficiency May Be Misdiagnosed as Cow’s Milk Allergy: Seven Cases Referred to a Tertiary Pediatric Hospital

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Karina Mescouto Melo ◽  
Ellen Dantas ◽  
Maria Isabel De Moraes-Pinto ◽  
Antonio Condino-Neto ◽  
Isabela G. S. Gonzalez ◽  
...  
Keyword(s):  
Immune System ◽  
Primary Immunodeficiency ◽  
Positive Family History ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

Introduction. The presence of eczema and gastrointestinal manifestations are often observed in cow’s milk allergy (CMA) and also in some primary immunodeficiency diseases (PID). Objective. To describe 7 patients referred to a tertiary allergy/immunology Center with a proposed diagnosis of CMA, who were ultimately diagnosed with PID. Methods. This was a retrospective study based on clinical and laboratory data from medical records. Results. Seven patients (6 males) aged between 3 mo and 6 y were referred to our clinic with a proposed diagnosis of CMA. They presented with eczema and/or gastrointestinal symptoms. Five were receiving replacement formula. All patients presented with other clinical features, including severe/recurrent infections unrelated to CMA, and two of them had a positive family history of PID. Laboratory tests showed immune system dysfunctions in all patients. Hyper-IgE and Wiskott-Aldrich syndromes, CD40L deficiency, severe combined immunodeficiency, X-linked agammaglobulinemia, transient hypogammaglobulinemia of infancy, and chronic granulomatous disease were diagnosed in these children. In conclusion, allergic diseases and immunodeficiency are a result of a different spectrum of abnormalities in the immune system and may be misdiagnosed. Educational programs on PID among clinical physicians and pediatricians can reduce the occurrence of this misdiagnosis.

Development of Food Allergies with Special Reference to Cow's Milk Allergy

PEDIATRICS ◽  
1985 ◽  
Vol 75 (1) ◽  
pp. 177-181
Author(s):  
Tony Foucard
Keyword(s):  
Wide Spectrum ◽  
Gastrointestinal Symptoms ◽  
Cow’S Milk Allergy ◽  
Food Allergies ◽  
Cow’S Milk ◽  
Gradual Change ◽  
Milk Allergy ◽  
Early Introduction ◽  
Cow's Milk ◽  
Cow's Milk Allergy

Using strict criteria, the incidence of cow's milk sensitivity is probably 1% to 2% during the first 2 years of life. Although there is a wide spectrum of sensitivity symptoms caused by cow's milk, two major groups of infants are discernible. One group consists of infants who react to small amounts of cow's milk within a few minutes up to one hour, usually with gastrointestinal symptoms or urticaria. These infants are often atopic and have positive findings on skin prick tests and radioallergosorbent test (RAST) reactions to cow's milk allergens. The other group consists of children whose reaction to cow's milk occurs one hour or longer after intake of cow's milk or cow's milk-based formula. These reactions are usually not immunoglobulin (Ig)E-mediated and different immune and nonimmune mechanisms probably cause the symptoms. The risk of developing cow's milk sensitivity seems to be influenced by the atopic constitution of the infant and the age at which cow's milk is introduced. Early exposure to cow's milk increases the risk, not only of adverse reactions to this milk but also of developing allergies to other foods. It is suggested that early introduction of cow's milk may enhance the risk of future respiratory allergies. Allergists are still not in agreement as to whether the weaning process should be rapid or should consist of a gradual change from breast milk to cow's milk in order to minimize the risk of cow's milk allergy.

How mothers perceive infants with unspecific gastrointestinal symptoms suggestive of cow's milk allergy?

2014 ◽  
Vol 103 (5) ◽  
pp. 524-528 ◽  
Author(s):  
Laura Merras-Salmio ◽  
Eeva T. Aronen ◽  
Mikael Kuitunen ◽  
Anna S. Pelkonen ◽  
Mika J. Mäkelä ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

scholarly journals Semi-Elemental and Elemental Formulas for Enteral Nutrition in Infants and Children with Medical Complexity—Thinking about Cow’s Milk Allergy and Beyond

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4230
Author(s):  
Elvira Verduci ◽  
Silvia Salvatore ◽  
Ilia Bresesti ◽  
Elisabetta Di Profio ◽  
Erica Pendezza ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Preterm Infants ◽  
Gastrointestinal Symptoms ◽  
Infants And Children ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Medical Complexity

Children with medical complexities, such as multi-system disorders and/or neurological impairments, often experience feeding difficulties and need enteral nutrition. They frequently have impaired motility and digestive–absorbing functions related to their underlying condition. If a cow’s milk allergy (CMA) occurs as a comorbidity, it is often misdiagnosed, due to the symptoms’ overlap. Many of the commercialized mixtures intended for enteral nutrition are composed of partially hydrolyzed cow’s milk proteins, which are not suitable for the treatment of CMA; thus, the exclusion of a concomitant CMA is mandatory in these patients for obtaining symptoms relief. In this review, we focus on the use of elemental and semi-elemental formulas in children with neurological diseases and in preterm infants as clinical “models” of medical complexity. In children with neurodisabilities, when gastrointestinal symptoms persist despite the use of specific enteral formula, or in cases of respiratory and/or dermatological symptoms, CMA should always be considered. If diagnosis is confirmed, only an extensively hydrolyzed or amino-acid based formula, or, as an alternative, extensively hydrolyzed nutritionally adequate formulas derived from rice or soy, should be used. Currently, enteral formulas tailored to the specific needs of preterm infants and children with neurological impairment presenting concomitant CMA have not been marketed yet. For the proper monitoring of the health status of patients with medical complexity, multidisciplinary evaluation and involvement of the nutritional team should be promoted.

scholarly journals Atopy patch tests are useful to predict oral tolerance in children with gastrointestinal symptoms related to non-IgE-mediated cow's milk allergy

Allergy ◽  
2012 ◽  
Vol 68 (2) ◽  
pp. 246-248 ◽  
Author(s):  
R. Nocerino ◽  
V. Granata ◽  
M. Di Costanzo ◽  
V. Pezzella ◽  
L. Leone ◽  
...  
Keyword(s):  
Oral Tolerance ◽  
Gastrointestinal Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Patch Tests ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Ige Mediated

scholarly journals Cow’s Milk Allergy: Immunomodulation by Dietary Intervention

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1399 ◽  
Author(s):  
Enza D’Auria ◽  
Silvia Salvatore ◽  
Elena Pozzi ◽  
Cecilia Mantegazza ◽  
Marco Ugo Andrea Sartorio ◽  
...  
Keyword(s):  
Immune System ◽  
Dietary Intervention ◽  
Physiological Mechanism ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Dietary Management ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

Cow’s milk proteins cause allergic symptoms in 2% to 3% of all infants. In these individuals, the physiological mechanism of tolerance is broken with subsequent possible sensitization to antigens, which can lead eventually to allergic responses. The present review aims to provide an overview of different aspects of immune modulation by dietary intervention in cow’s milk allergy (CMA). It focuses on pathogenetic mechanisms of different CMA related disorders, e.g., gastroesophageal reflux and eosinophilic esophagitis, highlighting the role of dietary management on innate and adaptive immune systems. The traditional dietary management of CMA has greatly changed in the last years, moving from a passive approach, consisting of an elimination diet to relieve symptoms, to a “proactive” one, meaning the possibility to actively modulate the immune system. Thus, new insights into the role of hydrolysates and baked milk in immunomodulation are addressed here. Additionally, nutritional components, such as pre- and probiotics, may target the immune system via microbiota, offering a possible road map for new CMA prevention and treatment strategies.

scholarly journals Lactose Intolerance: Common Misunderstandings

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 30-37 ◽  
Author(s):  
Margherita Di Costanzo ◽  
Roberto Berni Canani
Keyword(s):  
Lactose Intolerance ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Small Bowel Mucosa ◽  
Bowel Mucosa

Lactose intolerance primarily refers to a syndrome having different symptoms upon the consumption of foods containing lactose. It is one of the most common form of food intolerance and occurs when lactase activity is reduced in the brush border of the small bowel mucosa. Individuals may be lactose intolerant to varying degrees, depending on the severity of these symptoms. When lactose is not digested, it can be fermented by gut microbiota leading to symptoms of lactose intolerance that include abdominal pain, bloating, flatulence, and diarrhea with a considerable intraindividual and interindividual variability in the severity of clinical manifestations. These gastrointestinal symptoms could be similar to cow’s milk allergy and could be wrongly labeled as symptoms of “milk allergy.” There are important differences between lactose intolerance and cow’s milk allergy; therefore, a better knowledge of these differences could limit misunderstandings in the diagnostic approach and in the management of these conditions.

Sign in / Sign up

Export Citation Format

Share Document