How Can We Predict Yogurt Tolerance in Cow's Milk Allergy?

Area of Science:

• Allergy and Immunology
• Pediatric Gastroenterology
• Food Science

Background:

• Cow's milk allergy (CMA) is a common food allergy in children.
• Limited data exists on yogurt's impact on CMA management.
• Yogurt, a fermented dairy product, may have altered allergenicity.

Purpose of the Study:

• To assess yogurt tolerance in children with CMA via oral food challenge (OFC).
• To identify factors predicting OFC outcomes in IgE-mediated CMA.
• To evaluate the role of specific IgE, skin prick tests (SPT), and IgE/total IgE ratio in predicting yogurt tolerance.

Main Methods:

• Retrospective analysis of 132 children diagnosed with CMA.
• Categorization into IgE-mediated, non-IgE-mediated, and mixed-type reactions.
• Evaluation of demographic data, clinical history, laboratory results, SPT, and OFC results for yogurt.

Main Results:

• 68.2% of all participants and 51.5% of the IgE-mediated group tolerated yogurt.
• Significant differences in SPT wheal size, specific IgE, and IgE/total IgE ratio were observed between positive and negative OFC results in the IgE-mediated group (p<0.05).
• Cow's milk-specific IgE demonstrated high predictive value for any reaction/anaphylaxis during yogurt OFC (AUC 0.831-0.876).

Conclusions:

• Yogurt is tolerated by a substantial number of children with various forms of CMA.
• Cow's milk-specific IgE levels are valuable predictors of OFC outcomes in IgE-mediated CMA.
• Further research can refine predictive models for food challenges in pediatric food allergies.