Health and growth indices in children with cow’s milk protein allergy depending on oral tolerance development

2020 ◽  
pp. 33-37
Author(s):  
A. A. Galimova ◽  
E. E. Emelyashenkov ◽  
S. G. Makarova ◽  
N. N. Murashkin ◽  
A. P. Fisenko ◽  
...  
Keyword(s):  
Milk Protein ◽  
Challenge Test ◽  
Milk Proteins ◽  
Cow’S Milk ◽  
Growth Indices ◽  
Tolerance Development ◽  
Lower Growth ◽  
Cow's Milk ◽  
Ige Mediated ◽  
Cow’S Milk Protein

Relevance. Dairy-free diet is the basis of cow’s milk allergy (CMA) patient’s management. Duration of the diet is individual, but some children don’t develop tolerance.The aim of the study was to investigate health and growth indices in children with CMA depending on tolerance development by the age of five. Materials and methods. 153 children from 1 to 18 months with diagnosed CMA were included in the prospective study (76.5% with IgE-mediated form). The tolerance was determined after 6–12 months of a milk-free diet and at the age of 5 using an open challenge test. Anthropometry indices (Anthro Plus), levels of specific IgE (Immuno CAP 250) and IgG4 (ELISA) to dietary proteins and the presence of allergic diseases in children also were assessed.Results. 50.3% of children developed tolerance to cow’s milk protein after 6–12 months of a milk-free diet. By the age of 5 63.3% of patients had complete tolerance of dairy products. Partially formed tolerance was observed in 22.9%. 13.8% of patients still had clinical reactions to cow’s milk proteins. Patients with persistent CMA typically had IgE-mediated form, lower growth indices and multiple allergic pathology.Conclusion. The consideration of tolerance development predictors can allow to personalize the management of CMA. Additional researches are needed to clarify the causes of growth indices decline in children with persistent CMA. 

scholarly journals DIAGNOSTIC PREDICTORS OF TOLERANCE DEVELOPMENT IN THE ELIMINATION DIET IN CHILDREN WITH COW'S MILK PROTEIN ALLERGY

2021 ◽  
Vol 64 (1) ◽  
Author(s):  
Oksana Matsyura ◽  
◽  
Lesya Besh ◽  
Natalia Lukyanenko ◽  
Oksana Kovalska ◽  
...  
Keyword(s):  
Milk Protein ◽  
Tolerance Induction ◽  
Milk Proteins ◽  
Specific Ige ◽  
Elimination Diet ◽  
Cow’S Milk ◽  
Molecular Profile ◽  
Tolerance Development ◽  
Cow's Milk ◽  
Cow’S Milk Protein

Background. Cow's milk protein allergy is a topical issue in pediatrics. This disease affects 2-3% of young children. Methods. The study included 30 children with a confirmed cow’s milk protein allergy and a prescribed milk elimination diet. The children were observed for 36 months. The molecular profile was evaluated by detecting the major components of milk (Bos d 8, Bos d 5, Bos d 4), minor (Bos d 6), and cross-reactive with serum albumin (Fel d 2, Can f 3). Results. The study group included 46.7% of boys. The mean age of the subjects was 14.5±3.18 months. Nine of the 25 analyzed factors were identified in the course of our work by the method of logistic regression with progressive selection, which in combined action affect the formation of tolerance to cow's milk proteins in allergic children. There are three clinical examples of calculating the prediction of the complete tolerance development in the elimination diet in children with cow's milk protein allergy. Conclusions. Independent predictors that reduce the likelihood of the tolerance development in the elimination diet, have identified: skin test to milk, Bos d 8, Bos d 5, Bos d 4, Bos d 6. Independent predictors of the tolerance development in the elimination diet are: milk-specific IgE, total IgE, Fel d 2, Can f 3. Low probability of tolerance development by elimination therapy is a recommendation for prescribing treatment to a patient by specific oral tolerance induction.

scholarly journals Fecal Calprotectin and Eosinophil-Derived Neurotoxin in Children with Non-IgE-Mediated Cow’s Milk Protein Allergy

2021 ◽  
Vol 10 (8) ◽  
pp. 1595
Author(s):  
María Roca ◽  
Ester Donat ◽  
Ana Rodriguez Varela ◽  
Eva Carvajal ◽  
Francisco Cano ◽  
...  
Keyword(s):  
Milk Protein ◽  
Statistical Significance ◽  
Functional Gastrointestinal Disorders ◽  
Fecal Calprotectin ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Young Infants ◽  
Healthy Infants ◽  
Ige Mediated ◽  
Cow’S Milk Protein

Our aim is to assess the efficacy of fecal calprotectin (fCP) and fecal eosinophil-derived neurotoxin (fEDN) as diagnostic markers of cow’s milk protein allergy (CMPA) and for monitoring the infants’ response to a non-IgE mediated cow’s milk protein (CMP)-free diet. We prospectively recruited infants aged 0 to 9 months. Stool samples were taken from 30 infants with CMPA, 19 with mild functional gastrointestinal disorders, 28 healthy infants, and 28 children who presented mild infections. Despite the fact that levels of fCP and fEDN in CMPA infants were higher than in healthy infants at month 0, differences for both parameters did not reach statistical significance (p-value 0.119 and 0.506). After 1 month of an elimination diet, no statistically significant differences in fCP with basal levels were found (p-values 0.184) in the CMPA group. We found a high variability in the fCP and fEDN levels of young infants, and discrepancies in individual behavior of these markers after a CMP-free diet was started. It seems that neither fCP nor fEDN levels are helpful to discriminate between healthy infants and those with signs or symptoms related to non-IgE-mediated CMPA. Additionally, it is debatable if on an individual basis, fCP or fEDN levels could be used for clinical follow-up and dietary compliance monitoring. However, prospective studies with larger populations are needed to draw robust conclusions.

Faecal calprotectin as an aid to the diagnosis of non-IgE mediated cow's milk protein allergy

2016 ◽  
Vol 84 (6) ◽  
pp. 318-323 ◽  
Author(s):  
Carlos Trillo Belizón ◽  
Eduardo Ortega Páez ◽  
Antonio Medina Claros ◽  
Isabel Rodríguez Sánchez ◽  
Ana María Reina González ◽  
...  
Keyword(s):  
Milk Protein ◽  
Cow’S Milk ◽  
Faecal Calprotectin ◽  
Cow's Milk ◽  
Ige Mediated ◽  
Cow’S Milk Protein

Screening for Cow Milk Allergy Among Young Egyptian Children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Zeinab A El-Sayed ◽  
Rasha H El-Owaidy ◽  
Hanan M Abd El-Lateef ◽  
Ahmed SA Hammouda
Keyword(s):  
Milk Protein ◽  
Clinical History ◽  
Cow Milk ◽  
Cow’S Milk ◽  
Published Data ◽  
Cow's Milk ◽  
Oral Challenge Test ◽  
Egyptian Children ◽  
Ige Mediated ◽  
Cow’S Milk Protein

Abstract Background There are insufficient published data on the prevalence of cow's milk protein allergy (CMPA) in Egypt. Aim of the Work The study aims to estimate the frequency of CMPA among young Egyptian children in a trial to delineate the magnitude of the problem in our population. Methods A cross-sectional, observational study was conducted on 500 young Egyptian children from the general population aged from 6 months to 5 years; 200 males and 300 females. Children were subjected to history taking and clinical examination. Suspected cases with suggestive clinical history of CMPA were subjected to skin prick test (SPT) with standardized cow’s milk protein allergen extract and open oral challenge test (OCT). Results In the present study, 6.2% of screened children had positive clinical history suggestive of CMPA, 35.5% of them had positive SPT and 51.6% had positive OCT. Based on clinical history and OCT, 3.2% were documented to have CMPA, 3% had undocumented CMPA or low probability of CMPA and 93.8% had no CMPA. The highest rate of initial onset of CMPA is seen before the first year of life (96.8%) and 81.3% of children with positive OCT were formula/mixed-fed. The clinical manifestations in infants with suspected CMPA were variable, and the main presenting feature was gastrointestinal tract manifestations (42%). The IgE-mediated CMPA was more common and constituted 56.3% of the CMPA cases. Conclusion The frequency of CMPA among Egyptian children up to 5 years of age is comparable to the reported frequencies worldwide. IgE-mediated CMPA accounts for more than 2/3 of the patients with proven CMPA in this study.

Patients suffering from non-IgE-mediated cow’s milk protein intolerance cannot be diagnosed based on IgG subclass or IgA responses to milk allergens

Allergy ◽  
2011 ◽  
Vol 66 (9) ◽  
pp. 1201-1207 ◽  
Author(s):  
H. Hochwallner ◽  
U. Schulmeister ◽  
I. Swoboda ◽  
T. E. Twaroch ◽  
H. Vogelsang ◽  
...  
Keyword(s):  
Milk Protein ◽  
Cow’S Milk ◽  
Igg Subclass ◽  
Cow's Milk ◽  
Cow's Milk Protein Intolerance ◽  
Ige Mediated ◽  
Cow’S Milk Protein ◽  
Protein Intolerance
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