[Intolerance to cow's milk. Study of specific immunoglobulin E]

Area of Science:

• Allergy and Immunology
• Pediatric Gastroenterology
• Immunochemistry

Context:

• Cow's milk intolerance is a common concern in infants and young children.
• Accurate diagnosis is crucial for appropriate management and preventing complications.
• Specific IgE testing is a common diagnostic tool, but its efficacy for cow's milk proteins requires evaluation.

Purpose:

• To evaluate the diagnostic utility of specific IgE testing against alpha-lactalbumin, beta-lactoglobulin, and casein in children suspected of cow's milk intolerance.
• To compare the sensitivity of single-allergen RAST tests with a "total cow's milk proteins" RAST.
• To investigate the correlation between total IgE levels and specific IgE responses to cow's milk allergens.

Summary:

• The study analyzed sera from 164 children (8 days to 3 years) with suspected cow's milk intolerance using RAST for alpha-lactalbumin, beta-lactoglobulin, casein, and total cow's milk proteins.
• Intolerance was identified in 107 out of 180 tested sera, with alpha-lactalbumin and beta-lactoglobulin being frequently implicated.
• However, the "total cow's milk proteins" RAST demonstrated higher sensitivity than individual allergen tests, suggesting limited value of single-allergen testing alone.

Impact:

• Findings suggest that a "total cow's milk proteins" RAST may be more clinically relevant for diagnosing cow's milk intolerance in pediatric populations than tests for single allergens.
• The study highlights the importance of considering the overall protein profile rather than isolated components for accurate diagnosis.
• A significant positive correlation between total IgE levels and RAST positivity underscores the role of allergic sensitization in cow's milk intolerance.