Clinical practice. Diagnosis and treatment of cow’s milk allergy

Kneepkens, C. M. F.; Meijer, Y.

doi:10.1007/s00431-009-0955-7

Cited by 68 publications

(47 citation statements)

References 39 publications

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“…However, the incidence is significantly less in infants who are exclusively breastfed, at a rate of about 0.5% to 1% (Helm, 2014). The fact that cow's milk proteins (CMP) constitute the first food antigens to be introduced into the infant diet may partly explain this food allergy being the most frequent and precocious (Vandenplas et al, 2007;Kneepkens & Meijer, 2009;Drsi et al, 2009). The clinical presentation is generally moderate in infants, which can be explained by CMP concentration in breast milk (BM) being 100,000 times less than the concentration found in infant formulas (Table 1).…”

Section: Overviewmentioning

confidence: 99%

“…Also, environmental factors such as neonatal antecedents that alter the formation of intestinal flora, as well as prematurity, antibiotic therapy early in life, or early and sporadic contact with CMP in utero through breast milk or through occasional formula administration to infants seem to cause CMPA predisposition. Exclusive breastfeeding for four to six months appears to be a protective factor, for not only CMPA but also other food allergies (Vandenplas et al, 2007;Kneepkens & Meijer, 2009). …”

Section: Overviewmentioning

confidence: 99%

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Lactose intolerance and cow's milk protein allergy

et al. 2016

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Adverse reactions to food intake have very diverse etiology and symptomatology. Regarding milk, its food allergy is presented as lactose intolerance, the sugar in milk, or allergy to milk protein. Despite having different symptomatology, confusions among allergic conditions to dairy and its mediators are common. Milk protein allergy originates from protein components present in milk, causing reactions to either the protein fractions in emulsion (caseins) or in whey (milk albumin). The allergic reaction is type IV mediated by T lymphocytes. The allergic reaction produces severe cellular damage and it triggers physical, mental and emotional symptomatology that may vary in time, intensity and severity. Lactose intolerance is originated by total or partial absence of the enzyme that digests this disaccharide. Lactose intolerance can be primary or congenital and secondary; the former being more rare and severe, the latter being more common. Lactase deficiency can be diagnosed by symptoms associated with cramping and diarrhea. Thus, the objective of this study was to conduct a review of available literature on cow's milk protein allergy and lactose intolerance.Keywords: cow's milk; adverse reactions to food; immune response.Practical Application: Know and differentiate lactose intolerance and allergy to cow's milk protein.

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Section: Overviewmentioning

confidence: 99%

Section: Overviewmentioning

confidence: 99%

Lactose intolerance and cow's milk protein allergy

et al. 2016

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“…İlk bir yaşta açık kontrollü besin yükleme testi, 1-2 yaş-tan büyük çocuklarda ise çift kör plasebo kontrollü besin yükleme testi önerilir. Deri testleri ve spesifik IgE testi negatif olsa bile öykü kuvvetli ise yükleme testi yine de yapılmalıdır [1,[19][20][21]. Ancak anafilaksi öyküsü varsa yükleme testi kontrendikedir.…”

Section: Besin Yükleme Testleriunclassified

İnek sütü protein alerjisi

Koca¹,

Akçam²

2015

Dicle Med J

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Cow's Milk Protein Allergy (CMPA) is the most common food allergy in early childhood. It affects between 2% and 3% of infants. Symptoms and signs related to CMPA which IgE-mediated or non IgE-mediated may involve many different organ systems. The first and most important step in diagnosis is a thorough medical history. Results of laboratory tests alone are not sufficient to make diagnosis, always need to be considered together with the clinical features. CMPA can occur with multiple immunological mechanisms, therefore the diagnosis chance increases with use of numerous tests together. However, the negative test does not exclude the diagnosis. The gold standards in diagnosis are food elimination and challenge tests. Cow's milk and avoiding the use of its products, it is still considered as the first choice in the treatment of all children with CMPA.

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“…Como regra geral, os anti-histamínicos devem ser suspensos, mas não há consenso de quanto tempo antes do TPO o paciente deve evitar esse medicamento. Entre os trabalhos publicados, a recomendação varia de três a dez dias (9,11,12,24,(32)(33)(34) . Corticosteroides inalatórios podem ser mantidos em doses mínimas suficientes para controlar a asma, e os corticosteroides tópicos podem ser aplicados em pequenas áreas da pele (11,12,24) .…”

Section: Orientações Pré-testeunclassified

Teste de provocação oral aberto na confirmação de alergia ao leite de vaca mediada por IgE: qual seu valor na prática clínica?

Mendonça¹,

Cocco²,

Sarni³

et al. 2011

Rev. paul. pediatr.

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REsumoObjetivo: Revisar os principais protocolos de padronização para o teste de provocação oral aberto aplicado a crianças com suspeita de alergia ao leite de vaca mediada por imunoglobulina E.Fontes de dados: Foram selecionados artigos publicados, nos últimos dez anos, nas bases de dados Medline, Lilacs e SciELO, utilizando-se os descritores de assunto: "hipersensibilidade alimentar", "leite de vaca", "alergia ao leite de vaca", "teste de provocação oral", "crianças" e "diagnóstico".Síntese dos dados: O teste de provocação oral é o méto-do mais fidedigno para estabelecer ou excluir o diagnóstico de alergia alimentar e sua forma aberta pode ser a primeira opção, quando apenas reações objetivas são esperadas. O local para realizar o teste deve possuir todos os recursos para tratamento de emergência. Como preparo, o paciente deve seguir dieta de exclusão do alimento suspeito e descontinuar o uso de medicamentos que possam interferir no resultado do teste. Habitualmente, utilizam-se 8 a 10g de leite em pó ou 100mL de leite fluido, oferecidos em volumes progressivos, a intervalos de dez a 60 minutos. Apesar da rigidez do método, ainda existem situações em que há dificuldade de interpretação dos resultados; por isso, médicos bem treinados devem aplicar o teste, sendo cautelosos ao julgarem as reações.Conclusões: Mesmo considerando as limitações que dificultam a aplicação do teste de provocação oral na prática clínica, a implementação do teste nos serviços de saúde poderia reduzir diagnósticos falsos-positivos de alergias.Palavras-chave: hipersensibilidade alimentar; substitutos do leite humano; diagnóstico. AbsTRAcTObjective: To review the main standardization protocols of the open oral food challenge applied to children with suspicion of cow's milk allergy mediated by immunoglobulin E.Data source: Medline, Lilacs and SciELO databases were searched for articles published in the last ten years using the following descriptors: "food hypersensitivity", "cow's milk", "cow's milk allergy", "oral food challenge", "children" and "diagnosis".Data synthesis: The oral food challenge test is the most reliable method to establish or exclude the diagnosis of food allergy and the open challenge can be the first option when only objective reactions are expected. All medications and equipment needed for emergency treatment should be available. Before being submitted to the test, the patient must follow a diet excluding the suspected food and discontinue the use of medications that may interfere with the results of the test. Usually, it is performed using 8-10g of powdered milk or 100mL of fluid milk, offered in progressive volumes

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Clinical practice. Diagnosis and treatment of cow’s milk allergy

Cited by 68 publications

References 39 publications

Lactose intolerance and cow's milk protein allergy

Lactose intolerance and cow's milk protein allergy

İnek sütü protein alerjisi

Teste de provocação oral aberto na confirmação de alergia ao leite de vaca mediada por IgE: qual seu valor na prática clínica?

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