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Identifying and managing cow's milk protein allergy
George du Toit1, Rosan Meyer, Neil Shah
1King’s College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Allergy and Lung Biology, Guy’s and St Thomas’ NHS Foundation Trust, UK. george.dutoit@kcl.ac.uk
Insights
Cow
Area of Science:
- Pediatrics
- Allergy Immunology
- Clinical Nutrition
Background:
- Cow's milk protein (CMP) is a common early food for infants.
- CMP can cause various adverse reactions affecting skin, GI tract, and respiratory system.
- Understanding CMP allergy classification and diagnosis is crucial.
Purpose of the Study:
- To review the broad spectrum of cow's milk protein allergy manifestations.
- To provide an approach to diagnosing and treating CMP allergy.
- To highlight diagnostic challenges and treatment strategies.
Main Methods:
- Literature review focusing on CMP allergy.
- Analysis of classification and immunological basis of CMP-induced reactions.
- Evaluation of diagnostic modalities and treatment approaches.
Main Results:
- CMP allergy presents with immediate (IgE-mediated) and delayed-onset reactions.
- Delayed reactions include GI symptoms and chronic eczema.
- Accurate diagnosis requires understanding immunological mechanisms and diagnostic tool limitations.
Conclusions:
- Cow's milk protein allergy encompasses a wide range of symptoms.
- Effective management involves accurate diagnosis and dietary avoidance.
- Dietetic support is essential to prevent nutritional deficiencies during CMP avoidance.
Abstract:
Cow's milk protein (CMP) is usually one of the first complementary foods to be introduced into the infant's diet and is commonly consumed throughout childhood as part of a balanced diet. CMP is capable of inducing a multitude of adverse reactions in children, which may involve organs like the skin, gastrointestinal (GI) tract or respiratory system. The diagnosis of CMP-induced adverse reactions requires an understanding of their classification and immunological basis as well as the strengths and limitations of diagnostic modalities. In addition to the well-recognised, immediate-onset IgE-mediated allergies, there is increasing evidence to support the role of CMP-induced allergy in a spectrum of delayed-onset disorders ranging from GI symptoms to chronic eczema. The mainstay of treatment is avoidance of CMP; this requires dietetic input to ensure that this does not lead to any nutritional compromise. This review is intended to highlight the broad spectrum of manifestations of CMP allergy and to offer an approach to the diagnosis and treatment thereof.
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