Immunochemical study of the malabsorption syndrome with cow's milk intolerance

Savilahti, E

doi:10.1136/gut.14.6.491

Cited by 90 publications

(59 citation statements)

References 16 publications

(28 reference statements)

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“…In infants with intestinal CMA one study (6) showed that IgM and IgC were often increased, whereas in another study increases in the mean levels of IgM and IgC were insignificant (52). Positive challenges in children with intestinal CMA and with AD and CMA elicited no consistent changes in the serum concentrations of IgM and IgG (86,98).…”

Section: Antibodies To C M In Diseasementioning

confidence: 99%

“…Precipitating antibodies to CM are frequently, but not invariably present in children with CMA (6,52,69), whereas in patients in whom skin symptoms predominate the level is mostly normal (86). When CM is eliminated, IgA falls, and during a positive challenge test it is often seen to rise (52,98), such a rise being less frequent after short challenges and in patients with AD (86). Recently, low serum IgA had been found in one third of cases with CMA (47,50); in many other studies, however, such cases have not been seen (6,69,86).…”

Section: Antibodies To C M In Diseasementioning

confidence: 99%

“…In jejunal biopsy specimens from two children suspected to have CMA, increased numbers of IgE-containing cells and IgE were seen in the basement membranes and in the epithelium and connective tissues (105). In nine jejunal biopsy specimens taken immediately after a positive challenge test with CM, the numbers of IgE-containing cells were low and unchanged as compared with the numbers of specimens taken before challenge (98). Few if any IgE-containing cells were seen in the jejunal biopsy specimens of children with AD and CMA after a positive challenge with CM (86).…”

Section: Immediate Hypersensitivity Reaction (Type I Reagin-dependenmentioning

confidence: 99%

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Cow's Milk Allergy

Savilahti

1981

Allergy

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By the end of the last century prevention of waterborne infections by chlorination of water supplies, pasteurization of cow's milk (CM) and production of suitable, easily cleaned bottles and nipples for infants had made artificial infant feeding a relatively safe procedure. But in the early years of the present century unexplained difficulties were reported in infants fed with cow's milk; some of them had continuous diarrhoea and failed to thrive (103). It was speculated that such infants had difficulty in digesting foreign proteins, although they could readily assimilate those in breast milk. In the following years cases of anaphylactic shock caused by CM were described, one of them with a fatal outcome (29). Animal studies showed that one species produced precipitins to proteins of milk from another species, and this type of reaction to the foreign structure of CM proteins was presumed to account for the symptoms seen in infants (29). In 1906, precipitins to CM were found in blood from a marasmic infant fed with CM (80). A year later reports appeared describing successful desensitization: injections of small quantities of cow serum cured and prevented hypersensitivity to oral CM and its symptoms (102). This was not a solution to the problem, however, as treatment with serum caused severe reactions (95). The mechanism and components of C M causing these reactions were debated. Wernstedt suggested that the symptoms were due to altered reactivity to CM because of earlier contact with it, and proposed that it should be called allergy (119). Subsequently, the intestinal symptoms were shown to be caused by the whey fraction of CM (42). They were noted to vary in severity and disappeared with increasing age. A decade later (1921) urticaria was described as a symptom of CM hypersensitivity (104). By the 1930's and 40's however, CMA was considered a rare disease ( I 12), but the decrease in breast feeding in most developed countries has made cow's milk allergy (CMA) an important cause of infant morbidity and one of the best known and most frequently encountered problems in current infant feeding practices. DEFINITIONThe majority of infants can be reared on CM formulas without untoward effects. However, sensitive immunochemical methods show that they do react to the foreign proteins in CM. When the immunologic reactions to CM are associated with clinical symptoms, the child can be said to be allergic to CM (89). Obviously, the simplest and the most convincing way to verify cow's milk allergy (CMA) would be to demonstrate this either abnormally strong or qualitatively altered immune reaction to C M proteins. As yet, however, this cannot be done by any single test or combination of tests. Therefore the diagnosis of CMA has to be based on the clinical response to CM. In most cases it is enough to observe a favourable response to elimination of CM, reappearance of symptoms during one challenge test and their -disappearance on renewed elimination. When symptoms are severe it is unethical to perform more than one challenge.Ot...

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Section: Antibodies To C M In Diseasementioning

confidence: 99%

Section: Antibodies To C M In Diseasementioning

confidence: 99%

Section: Immediate Hypersensitivity Reaction (Type I Reagin-dependenmentioning

confidence: 99%

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Cow's Milk Allergy

Savilahti

1981

Allergy

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“…The combination of antigen with antibody can activate complement but one report of reduction of serum content of C3 after food challenge of presumably hypersensitive persons (70) was not confirmed (35).…”

Section: Other Indicesmentioning

confidence: 99%

“…For many years reports have appeared of adverse reactions to cow milk in infancy under such terms as "intolerance", "allergy", "idios^Ticrasy" and "intractable diarrhea" (26,(34)(35)(36)(37)(38)(39) and also to soybean (40), The reactions consisted of diarrhea, and often vomiting, with onset usually 12 to 36 h after ingestion of the offending food. This type of reaction may now be viewed as an acute gastroenteropathy.…”

Section: Acute Gastroenteropathymentioning

confidence: 99%