[Cow's milk protein intolerance in childhood. Review of 30 cases]

Retrospective clinical study of 30 cases of cow's milk protein intolerance with a long term follow-up (3-141/2 years) in 22 cases. The onset of the disease is usually in the first 6 months, following a short exposure to cow's milk proteins. A later onset is also possible, particularly following an intestinal infection which seems to favor the sensibilisation. Usually the digestive disturbances predominate and are often associated with respiratory, cutaneous and other general problems (especially unexplained prolonged fever). In about half the cases, laboratory studies reveal signs of exsudative enteropathy or generalized malabsorption with lesions of varying severity of the jejunal mucosa. Clinical observation and investigation allows us to divide the patients into three groups according to different manifestations: 1. acute anaphylactic, 2. chronic and benign (colitis), 3. chronic and severe, with accompanying malnutrition and intestinal malabsorption. This last category leads occasionally to diagnostic difficulties in distinguishing it from coeliac disease. Whatever manifestations encountered, the disease is usually transitory, and disappears between the age of 2 and 21/2 years, but can also persist for a much longer time. The long-term follow-up study showed complete catch-up growth, absence of further gastro-intestinal problems, and a low incidence of other allergic diseases (18%).