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

Yogurt is a type of fermented milk. There is limited information on the yogurt's effect on managing cow's milk allergy. The aim of this study was to determine the factors affecting tolerance to yogurt using an oral food challenge test in children with cow's milk allergy and investigate the role of the cow's milk-specific IgE levels, cow's milk skin prick test wheal diameters, and the cow's milk-specific IgE/total IgE ratio in predicting oral food challenge outcomes in the IgE-mediated cow's milk allergy group.This retrospective study analysed the demographic and clinical features, laboratory data, skin prick tests, and the results of the yogurt oral food challenge from the children diagnosed with cow's milk allergy.Of the 132 patients included in the study, 68 (51.5%) of them were categorised asIgE-mediated, while 27 (20.5%) and 37 (28%) of them were categorised as non-IgE-mediated and mixed-type reaction groups, respectively. The findings indicated that 68.2% of the study population and 51.5% of the IgE-mediated group are associated with the cow'smilk allergy tolerated yogurt. In the IgE-mediated cow's milk allergy group, skin prick test wheal diameters, cow's milk-specific IgE, and the cow's milk-specific IgE/total IgE ratio were determined to be significantly different between patients with positive and negative oral food challenge results (p<0.05). Cow's milk-specific IgE performance contributed more to predicting any reaction and/or anaphylaxis in the yogurt oral food challenge (area under the curve: 0.831and 0.876). The ratio and the skin prick test wheal diameter performance were lower in the probability of any reaction and/or anaphylaxis in the yogurt oral food challenge.This study suggests that yogurt may be tolerated by a significant proportion of children with various forms of cow's milk allergy.