scholarly journals Testing the Cow’s Milk-Related Symptom Score (CoMiSSTM) for the Response to a Cow’s Milk-Free Diet in Infants: A Prospective Study

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2402 ◽  
Author(s):  
Silvia Salvatore ◽  
Elisabetta Bertoni ◽  
Federica Bogni ◽  
Valentina Bonaita ◽  
Chiara Armano ◽  
...  
Keyword(s):  
Symptom Score ◽  
Immunoglobulin E ◽  
Gastrointestinal Symptoms ◽  
Cow’S Milk ◽  
P Value ◽  
Cow's Milk ◽  
Related Symptom ◽  
Receiver Operation Characteristic ◽  
Ige Mediated ◽  
A Prospective Study

The diagnosis of cow’s milk allergy (CMA) is particularly challenging in infants, especially with non-Immunoglobulin E (IgE)-mediated manifestations, and inaccurate diagnosis may lead to unnecessary dietary restrictions. The aim of this study was to assess the accuracy of the cow’s milk-related symptom score (CoMiSSTM) in response to a cow’s milk-free diet (CMFD). We prospectively recruited 47 infants (median age three months) who had been placed on a CMFD due to persisting unexplained gastrointestinal symptoms. We compared data with 94 healthy controls (median age three months). The CoMiSSTM score was completed at recruitment and while on the exclusion diet. In 19/47 (40%) cases a response to the diet occurred. At recruitment CoMiSSTM was significantly higher in cases compared to controls (median score 8 vs. 3; p-value: <0.05), 9 cases had a score ≥12 and 8/9 normalized on CMFD. An oral milk challenge was performed in all 19 responders and six of these had a positive reaction to cow’s milk (CM). In eight infants IgE allergy tests were positive. The receiver operation characteristic (ROC) curve identified a CoMISSTM score of 9 to be the best cut-off value (84% sensitivity, 85% specificity, 80% positive (PPV) and 88% negative predictive value (NPV)) for the response to CMFD. We found CoMiSSTM to be a useful tool to help identify infants with persisting gastrointestinal symptoms and suspected CMA that would benefit from CMFD.

scholarly journals Cow's Milk-related Symptom Score as a predictive tool for cow's milk allergy in Indian children aged 0–24 months

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Rajniti Prasad ◽  
Ravi Shankar Ayathu Venkata ◽  
Praveen Ghokale ◽  
Pavitra Chakravarty ◽  
Fahmina Anwar
Keyword(s):  
Symptom Score ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Indian Children ◽  
Predictive Tool ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Related Symptom

scholarly journals The Cow’s Milk-Related Symptom Score (CoMiSSTM): Health Care Professional and Parent and Day-to-Day Variability

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 438
Author(s):  
Yvan Vandenplas ◽  
Eva Carvajal ◽  
Stefaan Peeters ◽  
Nadine Balduck ◽  
Yesra Jaddioui ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Symptom Score ◽  
Intraclass Correlation ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Related Symptom ◽  
Awareness Tool ◽  
Absolute Agreement ◽  
Rater Variability

The Cow’s Milk-related Symptom Score (CoMiSSTM) was created as an awareness tool for cow’s milk allergy. The aim of the present study was to analyze the inter-rater variability between a pediatrician, parents, and day to day variability. A Health Care Professional (HCP) and parent filled in the CoMiSS independently and blinded for each other to evaluate inter-rater variability. In order to validate day-to-day variability, a parent filled in the CoMiSS during 3 consecutive days and was compared to the CoMiSS scored by the HCP. The absolute agreement between parent and HCP was 75%, and 92.6% and 100% with a tolerance of 0, 1, and 2 points, respectively, resulting in excellent agreement with an intraclass correlation coefficient (ICC) 0.981 (95% Confidence Interval 0.974–0.986, p < 0.001). Day-to-day variability during 3 consecutive days resulted in an absolute agreement of 30%, increasing to 80% and 88.6% when 2 and 3 points, respectively, were accepted. The ICC was excellent for the parental prospective scores (0.93, 95% CI 0.90–0.96; p < 0.001). Day-to-day variability indicates that CoMiSS has a moderate inter-rater reliability. A very low variability was observed when scored prospectively over three days. Data suggest that the CoMiSS can reliably be scored by parents without additional training.

scholarly journals Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSS™) Values in Symptomatic Infants

2021 ◽  
Vol 24 (4) ◽  
pp. 384
Author(s):  
Anna Kozłowska-Jalowska ◽  
Andrea Horvath ◽  
Yvan Vandenplas ◽  
Hania Szajewska
Keyword(s):  
Symptom Score ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Related Symptom

scholarly journals Atypical Food protein-induced enterocolitis syndrome in children: Is IgE sensitization an issue longitudinally?

2021 ◽  
Vol 49 (3) ◽  
pp. 73-82
Author(s):  
Athina Papadopoulou ◽  
Theano Lagousi ◽  
Elpiniki Hatzopoulou ◽  
Paraskevi Korovessi ◽  
Stavroula Kostaridou ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Allergic Diseases ◽  
Cow’S Milk ◽  
Food Protein ◽  
Cow's Milk ◽  
T Helper 2 ◽  
Term Evaluation ◽  
Ige Mediated ◽  
Trigger Mechanisms

Background: Food Protein-Induced Enterocolitis Syndrome (FPIES) is a clinically well-characterised, non-Immunoglobulin E (IgE)-mediated food allergy syndrome, yet its rare atypical presen-tation remains poorly understood.Objective: Aim of this study was to present the 10-year experience of a referral centre high-lighting the atypical FPIES cases and their long-term outcome.Methods: FPIES cases were prospectively evaluated longitudinally in respect of food outgrowth and developing other allergic diseases with or without concomitant IgE sensitisation.Results: One hundred subjects out of a total of 14,188 referrals (0.7%) were identified. At pre-sentation, 15 patients were found sensitised to the offending food. Fish was the most frequent eliciting food, followed by cow’s milk and egg. Tolerance acquisition was earlier for cow’s milk, followed by egg and fish, while found not to be protracted in atypical cases. Resolution was not achieved in half of the fish subjects during the 10-year follow-up time. Sensitisation to food was not related to infantile eczema or culprit food, but was related to sensitisation to aeroallergens. In the long-term evaluation, persistence of the FPIES or aeroallergen sensitisation was significantly associated with an increased hazard risk of developing early asthma symptoms. Conclusion: Sensitisation to food was related neither to eczema or culprit food nor to tolerance acquisition but rather to the development of allergic asthma through aeroallergen sen-sitisation. In addition to an IgE profile at an early age, FPIES persistence may also trigger mechanisms switching FPIES cases to a T-helper 2 cells immune response later in life, predis-posing to atopic respiratory symptoms; albeit further research is required.

scholarly journals Cow's Milk-Related Symptom Score in Presumed Healthy Polish Infants Aged 0–6 Months

2020 ◽  
Vol 23 (2) ◽  
pp. 154
Author(s):  
Karolina Bigorajska ◽  
Zuzanna Filipiak ◽  
Paulina Winiarska ◽  
Anita Adamiec ◽  
Bogumiła Trent ◽  
...  
Keyword(s):  
Symptom Score ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Related Symptom

scholarly journals Evaluation of some predictive parameters for baked milk tolerance in children with cow's milk allergy

2021 ◽  
Vol 49 (2) ◽  
pp. 53-59
Author(s):  
Mehmet Kilic ◽  
Lütfiye Çilkol ◽  
Erdal Taşkın
Keyword(s):  
Immunoglobulin E ◽  
Food Challenge ◽  
Cow’S Milk ◽  
Milk Products ◽  
Prick Test ◽  
Cow's Milk ◽  
Predictive Parameters ◽  
Decision Points ◽  
Ige Mediated ◽  
Baked Milk

Background: Inclusion of baked-milk products to the diet appears to markedly accelerate tolerance to unheated milk compared to a strict avoidance diet.Objective: The present study aims to investigate the predictors of baked-milk tolerance in children with Immunoglobulin E (IgE)-mediated cow’s milk (CM) allergy.Methods: The study included 80 patients diagnosed with IgE-mediated CM allergy upon oral food challenge (OFC) testing at our clinic. Patients who developed and did not develop reactions during OFC with baked milk were compared considering clinical and laboratory parameters.Results: Eighty patients with CM allergy comprised 48 male and 32 female infants with an average age of 7.25 ± 2.45 (3–13) months. We found that 62.5% of them showed tolerance to baked milk in the OFC test performed with cakes containing 2.6-g milk protein. When the patients who tolerated and could not tolerate baked-milk products were compared for test results, we detected a statistically significant intergroup difference regarding diameter of wheal in skin prick test (SPT) performed with muffin slurry, levels of specific Immunoglobulin E (sIgE) in CM, sheep’s milk (SM), goat’s milk (GM), casein, and the amount of unheated milk consumed until a reaction developed in the OFC test performed with unheated milk (P < 0.05).Conclusion: We defined novel decision points based on CM, SM, GM, casein sIgE levels, wheal diameter in SPT with muffin slurry, and the amount of milk ingested during OFC performed with unheated milk that may be useful in predicting outcomes of baked-milk ingestion.

scholarly journals Atopy patch tests are useful to predict oral tolerance in children with gastrointestinal symptoms related to non-IgE-mediated cow's milk allergy

Allergy ◽  
2012 ◽  
Vol 68 (2) ◽  
pp. 246-248 ◽  
Author(s):  
R. Nocerino ◽  
V. Granata ◽  
M. Di Costanzo ◽  
V. Pezzella ◽  
L. Leone ◽  
...  
Keyword(s):  
Oral Tolerance ◽  
Gastrointestinal Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Patch Tests ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Ige Mediated

A workshop report on the development of the Cow's Milk-related Symptom Score awareness tool for young children

2015 ◽  
Vol 104 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Yvan Vandenplas ◽  
Christophe Dupont ◽  
Philippe Eigenmann ◽  
Arne Host ◽  
Mikael Kuitunen ◽  
...  
Keyword(s):  
Young Children ◽  
Symptom Score ◽  
Cow’S Milk ◽  
Workshop Report ◽  
Cow's Milk ◽  
Related Symptom ◽  
Awareness Tool
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