Anaphylactic reaction to goat's milk in a cow's milk‐allergic infant

Abstract

Goat's milk has been used as a substitute for cow's milk in cow's milk-allergic individuals. It is currently advocated for this purpose in writings and internet resources directed at the lay person, and infant formula based on goat's milk is available in many countries. Clinically significant cross-allergenicity between cow's and goat's milk has been noted, but a life-threatening cross-reaction has not been reported. We describe a 4-month-old infant with immunologically documented cow's milk protein allergy but no prior exposure to goat's milk who developed anaphylaxis after the ingestion of commercial goat's milk. Subsequent skin prick testing demonstrated a specific reaction to goat's milk. Thus, the cross-allergenicity between cow's and goat's milk proteins can lead to life-threatening complications. Individuals allergic to cow's milk protein should avoid goat's milk and goat's milk products.

Composition, nutritional and therapeutic values of goat milk: A review

“…Some people with cow milk allergy do tolerate goat milk, probably because of low  S1 -ceasein levels. However, several studies reports extensive cross-reactivity between cow and goat milk, caused by cow milk specfic IgE antibodies (Pessler and Nejat, 2004). Because of the cross reactivity all scientific reports dissuade persons with cow milk allergy to ingest goat milk.…”

Levels of inflammatory cytokines from peripheral blood mononuclear cells of children with cow’s milk protein allergy

“…Preventing the onset of inappropriate elimination diets in children with CMPA is important (4). In fact, the only effective treatment for CMPA is the total avoidance of cows' milk, which has to be replaced by appropriate substitutes (6), including soy formulas or casein, extensively hydrolyzed whey formulas or other mammalian milks such as goat's milk (7), which is frequently used although several studies raised concerns regarding its tolerability and safety, particularly in children (3,8,9).The immune reaction to cow's milk proteins is determined by immunoglobulin (Ig)-E or non-IgE-mediated type of response (10). Currently, the diagnosis relies both on IgE tests, such as the skin prick test, and measurement of serum-specific IgE antibody levels to cow's milk (1).…”

Is Undiluted Goat᾽s Milk Part of your Differential Diagnosis for Neonatal Metabolic Acidosis?

“…Finally, in addition to severe electrolyte abnormalities and metabolic acidosis, unmodified goat's milk has also been associated with megaloblastic anemia, allergic reactions including life-threatening anaphylactic shock, hemolytic uremic syndrome, and infection [10][11][12][13].…”