Cow's milk protein allergy. A multi-centre study: clinical and epidemiological aspects

Area of Science:

• Pediatric Allergy
• Immunology
• Gastroenterology

Background:

• Cow's milk protein allergy (CMPA) diagnosis is crucial to prevent unnecessary dietary restrictions in infants.
• Accurate diagnosis requires understanding the epidemiological, clinical, and evolutionary characteristics of CMPA.

Purpose of the Study:

• To investigate the epidemiological, clinical, and evolutionary features of cow's milk protein allergy (CMPA) in infants.
• To assess the effectiveness of a diagnostic protocol for CMPA.

Main Methods:

• Multi-center study involving 14 Children's Hospitals.
• Included 409 infants with suspected CMPA; detailed clinical history collected.
• Diagnostic methods included prick tests, specific IgE determination, and cow's milk challenge tests (3-day and 1-day regimens).

Main Results:

• Diagnostic challenge test performed on 286 infants; 123 excluded as not indicated.
• IgE-mediated allergy confirmed in 58% (234 infants); non-IgE-mediated hypersensitivity in 4% (15 infants).
• Average reaction age: 3.5 months; symptoms typically appeared within the first week of introduction (95%) and within 30 minutes of feeding (majority). Cutaneous signs were most frequent (94%).

Conclusions:

• Implementing an appropriate diagnostic protocol effectively rules out CMPA in a significant percentage of infants.
• The diagnostic challenge test regimens were found to be equally safe.