scholarly journals Oral Provocation Test On The Diagnosis Of Cow'S Milk Protein Allergy In Children: Integrative Review

10.3823/1741 ◽  
2015 ◽  
Author(s):  
Maria do Carmo Andrade Duarte de Farias ◽  
Loianne Pereira Araruna ◽  
Daniel Fonsêca de Miranda ◽  
Bárbara Carvalho Dantas ◽  
Eliane de Sousa Leite ◽  
...  
Keyword(s):  
Milk Protein ◽  
Provocation Test ◽  
Integrative Review ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Oral Provocation ◽  
Oral Provocation Test ◽  
Cow’S Milk Protein

scholarly journals Algorithm of conducting oral provocation tests with milk in 1–3-year-old children: analysis of existing standards and own experience

2021 ◽  
Keyword(s):  
Milk Protein ◽  
Specific Ige ◽  
Physical Development ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Oral Provocation ◽  
Provocation Tests ◽  
Cow’S Milk Protein

Introduction. Food allergy is an urgent problem in modern pediatrics. Cow’s milk is the main food allergen in young children. By the age of one year, from 0.5 % to 3 % of children suffer from cow’s milk protein allergy. Aim. To analyze the existing standards of conducting oral provocation tests with milk in young children and suggest own algorithm of diagnostics. Materials and methods. Algorithm of diagnosing cow’s milk allergy was probated in 107 children aged from one to three years in Communal Municipal Children’s Clinical Hospital. To diagnose cow’s milk allergy, compilation of allergological anamnesis, examination, assessment of physical development, and determination of specific IgE to cow’s milk are performed. Then, different oral provocation tests are conducted based on the obtained results: at the allergist’s office on an outpatient basis, in a specialized inpatient department, in an intensive care unit. Results. Among 107 children, who were subjected to oral provocation test with milk, cow’s milk protein allergy was diagnosed in 67 (62.62 %). In children, who were diagnosed cow’s milk protein allergy (n = 67), skin (41.79 %) and gastrointestinal (28.36 %) symptoms prevailed. In the group of children with predictable low risk of allergy, diameter of a papule equaled 3.86 ± 0.62 mm2, the level of specific IgE to milk in blood serum was 0.58 [0.37–0.68], and in the group with medium risk – 5.51 ± 1.38 mm2 and 3.62 [0.86–9.66] kU/L, respectively. All 40 children, in whom cow’s milk protein allergy was not confirmed, constituted the group with predictable low risk of reaction development. Diameter of a papule during prick-test equaled 3.13 ± 0.24 mm2, the level of specific IgE to milk in blood serum was 0.36 [0.35–0.67] kU/L. In this group of children, complaints of gastrointestinal symptoms (82.5 %) prevailed. Conclusions. A complex diagnostic approach, in particular, study of anamnesis, examination, assessment of physical development, record of food diary, determination of specific IgE to milk, oral provocation tests enable to optimize diagnostics of food allergy and choose further therapeutic tactics. Algorithm of diagnosing cow’s milk protein allergy in 1–3-year-old children has been elaborated, which can be recommended for common application in clinical practice.

scholarly journals Evaluation of the Skin-prick Test for Predicting the Outgrowth of Cow's Milk Allergy

2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0175 ◽  
Author(s):  
Jun Kido ◽  
Megumi Hirata ◽  
Hiroe Ueno ◽  
Natsuko Nishi ◽  
Masaho Mochinaga ◽  
...  
Keyword(s):  
Skin Prick Test ◽  
Provocation Test ◽  
Cow’S Milk ◽  
Test Results ◽  
Prick Test ◽  
Cow's Milk ◽  
Oral Provocation ◽  
Wheal Diameter ◽  
Oral Provocation Test ◽  
Wheal Size

Background Although considerable efforts have been made to develop diagnostic tools for predicting the outcome of oral food challenges, tests for predicting the outgrowth of food allergies are lacking. Objective The aim of this study was to assess the diagnostic value of the wheal size and skin index (SI) (the ratio of an allergen-induced wheal to a histamine-induced wheal diameter) of the skin-prick test based on the outcome of a controlled oral provocation test for cow's milk. Moreover, we assessed whether wheal size and/or SI were useful for predicting the outgrowth of cow's milk allergy (CMA). Methods This study included 135 children with suspected CMA. Eighty-one patients were definitely diagnosed by oral provocation tests for cow's milk, and their wheal diameters, SIs, and cow milk's–specific serum immunoglobulin E concentrations were determined. Results The wheal diameters were significantly larger and the SIs significantly higher in children with positive oral provocation test results than in those with negative test results. We found that 50% of the patients were expected to be able to drink cow's milk by age 5 years. In these patients, the wheal diameters were significantly smaller and the SIs significantly lower at the time of CMA outgrowth than at the time of diagnosis, whereas these values were apt to increase in patients who did not outgrow CMA, with no significant difference. Conclusions The skin-prick test can be used to diagnose CMA and predict CMA outgrowth. A wheal diameter of 8 mm or/and an SI of 1.0 is informative, not only in diagnosing CMA but also in predicting a natural CMA outgrowth.

scholarly journals O5 The prevalence of cow’s milk protein allergy in infants with gastroschisis and intestinal failure type 2 and 3

2021 ◽  
Author(s):  
Kornilia Nikaki ◽  
Tracey Johnson ◽  
Haidee Norton ◽  
Gabis Chana ◽  
Amrita Garcha ◽  
...  
Keyword(s):  
Milk Protein ◽  
Intestinal Failure ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Failure Type ◽  
Cow’S Milk Protein

scholarly journals Fecal Calprotectin and Eosinophil-Derived Neurotoxin in Children with Non-IgE-Mediated Cow’s Milk Protein Allergy

2021 ◽  
Vol 10 (8) ◽  
pp. 1595
Author(s):  
María Roca ◽  
Ester Donat ◽  
Ana Rodriguez Varela ◽  
Eva Carvajal ◽  
Francisco Cano ◽  
...  
Keyword(s):  
Milk Protein ◽  
Statistical Significance ◽  
Functional Gastrointestinal Disorders ◽  
Fecal Calprotectin ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Young Infants ◽  
Healthy Infants ◽  
Ige Mediated ◽  
Cow’S Milk Protein

Our aim is to assess the efficacy of fecal calprotectin (fCP) and fecal eosinophil-derived neurotoxin (fEDN) as diagnostic markers of cow’s milk protein allergy (CMPA) and for monitoring the infants’ response to a non-IgE mediated cow’s milk protein (CMP)-free diet. We prospectively recruited infants aged 0 to 9 months. Stool samples were taken from 30 infants with CMPA, 19 with mild functional gastrointestinal disorders, 28 healthy infants, and 28 children who presented mild infections. Despite the fact that levels of fCP and fEDN in CMPA infants were higher than in healthy infants at month 0, differences for both parameters did not reach statistical significance (p-value 0.119 and 0.506). After 1 month of an elimination diet, no statistically significant differences in fCP with basal levels were found (p-values 0.184) in the CMPA group. We found a high variability in the fCP and fEDN levels of young infants, and discrepancies in individual behavior of these markers after a CMP-free diet was started. It seems that neither fCP nor fEDN levels are helpful to discriminate between healthy infants and those with signs or symptoms related to non-IgE-mediated CMPA. Additionally, it is debatable if on an individual basis, fCP or fEDN levels could be used for clinical follow-up and dietary compliance monitoring. However, prospective studies with larger populations are needed to draw robust conclusions.

Differential Cytokine Expression in the Duodenum and Rectum of Children with Non-Immunoglobulin E-Mediated Cow’s Milk Protein Allergy

2021 ◽  
Author(s):  
Erick M. Toro-Monjaraz ◽  
Gabriela Fonseca-Camarillo ◽  
Flora Zárate-Mondragón ◽  
Ericka Montijo-Barrios ◽  
José Cadena-León ◽  
...  
Keyword(s):  
Milk Protein ◽  
Immunoglobulin E ◽  
Cytokine Expression ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Cow’S Milk Protein

scholarly journals The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow’s Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1169
Author(s):  
Bożena Cukrowska ◽  
Aldona Ceregra ◽  
Elżbieta Maciorkowska ◽  
Barbara Surowska ◽  
Maria Agnieszka Zegadło-Mylik ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Lactobacillus Casei ◽  
Milk Protein ◽  
Lactobacillus Rhamnosus ◽  
Cow’S Milk ◽  
Controlled Study ◽  
Symptom Improvement ◽  
Cow's Milk ◽  
Probiotic Preparation ◽  
Cow’S Milk Protein

Probiotics seem to have promising effects in the prevention and treatment of allergic conditions including atopic dermatitis (AD) and food allergy. The purpose of this multicenter randomized placebo-controlled trial was to evaluate the effectiveness of a probiotic preparation comprising Lactobacillus rhamnosus ŁOCK 0900, Lactobacillus rhamnosus ŁOCK 0908, and Lactobacillus casei ŁOCK 0918 in children under 2 years of age with AD and a cow’s milk protein (CMP) allergy. The study enrolled 151 children, who—apart from being treated with a CMP elimination diet—were randomized to receive the probiotic preparation at a daily dose of 109 bacteria or a placebo for three months, with a subsequent nine-month follow-up. The primary outcomes included changes in AD symptom severity assessed with the scoring AD (SCORAD) index and in the proportion of children with symptom improvement (a SCORAD score decreased by at least 30% in comparison with that at baseline). After the three-month intervention, both the probiotic and placebo groups showed a significant (p < 0.0001) decrease in SCORAD scores, which was maintained nine months later. The percentage of children who showed improvement was significantly higher in the probiotic than in the placebo group (odds ratio (OR) 2.56; 95% confidence interval (CI) 1.13–5.8; p = 0.012) after three months. Probiotics induced SCORAD improvement mainly in allergen sensitized patients (OR 6.03; 95% CI 1.85–19.67, p = 0.001), but this positive effect was not observed after nine months. The results showed that the mixture of probiotic ŁOCK strains offers benefits for children with AD and CMP allergy. Further research is necessary to assess the effect of probiotic supplementation on the development of immune tolerance. (ClinicalTrials.gov NCT04738565)

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