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Fecal calprotectin levels in pediatric cow's milk protein allergy
Dominika Lendvai-Emmert1,2,3, Vanessza Emmert1,4, Alexandra Makai1,5
1Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
Insights
Cow's milk protein allergy (CMPA) in children can be diagnosed using fecal calprotectin (FC). Strict adherence to a dairy elimination diet significantly reduces FC levels and improves symptoms.
Area of Science:
- Pediatric Allergy and Immunology
- Gastroenterology
- Clinical Diagnostics
Background:
- Cow's milk protein allergy (CMPA) is a common food allergy in young children, often presenting as allergic colitis.
- Objective assessment of CMPA and its response to dietary intervention is crucial for effective management.
Purpose of the Study:
- To assess somatic symptoms of CMPA in children.
- To prospectively evaluate the effects of a dairy elimination diet on objective parameters and clinical symptoms.
Main Methods:
- A study involving 47 children (aged 1-18) with suspected CMPA was conducted.
- Fecal calprotectin (FC) levels were measured at diagnosis and after a 3-month elimination diet using a rapid test.
- Patients completed questionnaires, and adherence to the diet was monitored.
Main Results:
- Overall, no significant difference in FC levels was observed after the 3-month diet (p=0.331).
- However, patients strictly adhering to the elimination diet showed a significant decrease in FC levels (p=0.001).
Conclusions:
- Fecal calprotectin (FC) can serve as an objective marker for diagnosing CMPA.
- Significant clinical improvement and reduction in FC levels are associated with strict adherence to a dairy elimination diet.
Introduction:
The most prevalent food allergy in younger children is cow's milk protein allergy (CMPA), a hypersensitivity reaction to cow's milk protein and its most common clinical manifestation is allergic colitis. The goal of our recent study was to assess somatic symptoms of CMPA and to prospectively observe the effects of a dairy elimination diet using objective parameters and questionnaires.
Methods:
The County Hospital in Szekszárd, Hungary, investigated children aged 1 to 18 who had clinical signs that might indicate CMPA. Stool samples were taken and analyzed using a fecal calprotectin (FC) rapid test (Quantum Blue fCAL, Bühlmann Laboratories, Switzerland) at the time of the diagnosis and following 3 months of an elimination diet. At the baseline visit as well as the first and second follow-up, questionnaires were filled out. Patients were divided into two subgroups according to dietary guidelines based on the results of the questionnaires.
Results:
A total of 47 patients participated in the study [42.55% female, mean age: 7.36 (SD 4.22) years]. There was no significant difference in FC levels between baseline and after 3-month elimination diet [73.98 (71.12) μg/g and 68.11 (74.4) μg/g, respectively, p = 0.331]. After three months, there was a significant decrease in FC levels among patients who adhered to the strict diet [84.06 (79.48) μg/g and 41.11 (34.24) μg/g, respectively, p = 0.001].
Conclusion:
The findings of our study suggest that FC can be an objective marker in confirming the diagnosis of CMPA. Significant improvement in clinical symptoms and in FC levels can only be expected after a strictly followed elimination diet.
