Related Experiment Videos
Cow's milk allergy
1Department of Intern Medicine, Clinical Immunology and Allergy-Hôpital Central, Nancy.
Allergie Et Immunologie
|August 12, 1999
Summary
Cow's milk allergy affects 2-5% of children, with increasing cases of multiple food allergies. Diagnosis requires lengthy milk challenges, and management involves specialized formulas and evolving tolerance protocols.
Area of Science:
- Pediatrics
- Allergology
- Immunology
Background:
- Cow's milk allergy (CMA) prevalence remains stable at 2-5%.
- Emerging research highlights gastroesophageal reflux and persistent constipation as potential symptoms.
- A significant trend is the rising incidence of multiple food allergies.
Purpose of the Study:
- To review the diagnostic challenges and management strategies for cow's milk allergy.
- To discuss the evolving landscape of food allergen sensitization.
- To provide an overview of current treatment and tolerance protocols.
Main Methods:
- The review synthesizes information from 98 references.
- Diagnostic criteria emphasize double-blind, placebo-controlled milk challenges (DBPCFC), which can be lengthy (up to 8 days).
- Evaluation of diagnostic markers like IgE-dependent sensitization, lymphocyte activation, and specific tests (ECP, methylhistamine, tryptase) in conjunction with challenges.
Main Results:
- DBPCFC are considered mandatory for CMA diagnosis.
- The diagnostic utility of immunological tests (ECP, methylhistamine, tryptase) alongside challenges is not consistently informative.
- Dietary management includes dairy product exclusion with substitutions like casein hydrolysates, pork collagen, soy hydrolysates, or amino acid-based formulas.
Conclusions:
- Standardization of tolerance induction protocols is lacking, though valuable methods exist.
- Accurate diagnosis and effective management of CMA, especially with co-existing allergies, remain critical.
- Further research is needed to refine diagnostic accuracy and standardize tolerance protocols.