Is it just lactose intolerance?

Area of Science:

• Gastroenterology
• Allergology
• Immunology

Background:

• Acquired delayed-onset hypolactasia (lactose intolerance) is common.
• Cow's milk allergies can present with similar symptoms, potentially worsening lactose intolerance.
• Refractory lactose intolerance despite a lactose-free diet warrants further investigation.

Purpose of the Study:

• To evaluate IgE-mediated cow's milk sensitization in adults with lactose-free diet refractory lactose intolerance.
• To determine the contribution of cow's milk allergy to persistent symptoms in these patients.

Main Methods:

• Skin-prick tests for cow's milk, goat's milk, and soy protein-specific IgE.
• SDS-PAGE immunoblotting to detect cow's milk protein-specific IgE.
• Study included 46 adult patients with persistent lactose intolerance symptoms.

Main Results:

• High prevalence of skin reactions to cow's milk and its proteins (up to 69.5%).
• Significant IgE detection against cow's milk proteins (alpha-lactalbumin, beta-lactoglobulin, caseins) via immunoblotting (up to 67.3%).
• Elevated sensitization rates to goat's milk (54.3%) and soy (50%) were also observed.

Conclusions:

• IgE-mediated cow's milk sensitization is a frequent comorbidity in adults with refractory lactose intolerance.
• Consideration of cow's milk allergy is crucial for managing patients with persistent lactose intolerance symptoms.
• This highlights the importance of differentiating allergies from intolerances for effective treatment.