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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...
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Position document: IgE-mediated cow's milk allergy.

A Martorell-Aragonés1, L Echeverría-Zudaire2, E Alonso-Lebrero3

  • 1Allergy Department, H General Universitario, Valencia, Spain.

Allergologia Et Immunopathologia
|March 25, 2015
PubMed
Summary
This summary is machine-generated.

Cow's milk allergy (CMA) affects 1.6-3% of infants, with diagnosis confirmed by clinical history, allergy tests, and controlled exposure. Effective management involves elimination diets and substitution formulas, with most infants outgrowing CMA within years.

Keywords:
ChildrenCow's milk allergyCow's milk protein hydrolysatesDiagnosisFood allergyOral immunotherapyOutcomesToleranceTreatment

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Area of Science:

  • Pediatrics
  • Allergology
  • Immunology

Background:

  • Cow's milk allergy (CMA) is a common disorder in infants, affecting 1.6-3% of the pediatric population.
  • Key allergens include casein and whey proteins (beta-lactoglobulin, alpha-lactoalbumin), leading to varied symptoms affecting skin, GI, and respiratory systems.
  • Severe reactions like anaphylaxis can occur.

Purpose of the Study:

  • To provide updated recommendations for managing pediatric patients with cow's milk allergy.
  • To outline diagnostic criteria and effective treatment strategies for CMA.
  • To discuss the prognosis and emerging treatment options for persistent CMA.

Main Methods:

  • Diagnosis relies on clinical history, positive allergy studies, and gold-standard controlled food challenges.
  • Management focuses on elimination diets, excluding all mammalian milk due to cross-reactivity risks.
  • Substitution formulas are essential for nutritional adequacy.

Main Results:

  • Most infants with IgE-mediated CMA achieve tolerance within the first few years of life.
  • Oral immunotherapy is an emerging option for persistent CMA but not yet standard practice.
  • Evidence does not support maternal/infant elimination diets or prebiotic/probiotic supplements for CMA prevention.

Conclusions:

  • CMA management requires a confirmed diagnosis and appropriate dietary interventions.
  • While most infants outgrow CMA, persistent cases may benefit from novel therapies.
  • Preventive strategies like dietary elimination or supplements are not currently recommended.