Retrospective evaluation of cases with cow's milk allergy

Abstract

Introduction: Cow's milk allergy (CMA) is described as immunological reaction against to one or more milk proteins. It is known that CMA which affects about 1-3% of the general population is the most commonly seen food allergy in infants and children. It is well known that a tolerance develops and prognosis is better during the first three years of the life. In the present study, we aimed to investigate the natural course of cases diagnosed with CMA and to determine the factors which have impact on the tolerance development.Materials and Methods: Medical records of cases who have been followed for CMA were retrospectively reviewed. Gender, age at first symptom, breastfeeding duration, family atopy history, multiple food allergies, concomitant allergic diseases, inhalant allergy sensitivity and clinical manifestation of cases were assessed. Also, prick test results, milk-specific IgE, casein-specific IgE and the reactions that developed during food challenge test were evaluated.Results: The age at first symptom was mean 4 +/- 2,3 months. Twenty-two percent of patients had a positive family history of atopy and 30% had multiple food allergies. There were concomitant allergic disorders in 58% of patients. Skin (93.8%), gastrointestinal system (GIS) (24.7%) and respiratory system (18.5%) symptoms were most commonly seen. The percentage of tolerance development by the years was determined as 41% for the first year, 64% for the second year and 75% for the third year. Milk-specific IgE level at the time of diagnosis (p=0.010) and asthma presence (p=0.010) were found significant risk factors for persistent CMA.Conclusion: Clinical parameters and allergy tests may help to predict the prognosis of CMA. Milk-specific IgE level at the time of diagnosis is the risk factor for persistent CMA.