Non-IgE-Mediated Cow Milk Allergy Is Linked to Early Childhood Clusters of Commonly Seen Illnesses

Gibbons, Troy; Patil, Sowmya; Frem, Juliana C.; Smith, Chandra; Wakwe, Josephine; Swearingen, Christopher J.

doi:10.1177/0009922811425234

Cited by 14 publications

(31 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cow’s milk is not recommended until after 12 months of age, because its composition is significantly different to breast milk and infant formula, and its use can lead to iron deficiency [36, 37]. Another consideration is cow’s milk protein allergy, which is associated with TTP [38]. We did not find infant formula to be a risk factor, even though it usually contains cow’s milk.…”

Section: Discussionmentioning

confidence: 94%

Determinants of chronic otitis media with effusion in preschool children: a case–control study

et al. 2017

View full text Add to dashboard Cite

BackgroundChronic otitis media with effusion (COME) is a prevalent upper airway infection resulting in hearing loss. The aim of this research was to determine risk factors for COME in preschool children.MethodsA case–control design was conducted in Auckland, New Zealand from May 2011 until November 2013. The cases were children aged 3 and 4 years referred for tympanostomy tube placement due to a diagnosis of COME (n = 178). The controls were a random sample of healthy children aged 3 and 4 years from primary care practices (n = 209). The children’s guardians completed an interviewer-administered questionnaire that covered topics including socio-demographic information, pregnancy and birth, infant feeding practices, home environment, and respiratory health. In addition, skin prick tests for atopy were performed. Odds ratios (OR) estimating the risk of COME independently associated with the exposures were calculated using a logistic regression model.ResultsChildren with COME frequently had nasal obstruction (OR: 4.38 [95% CI: 2.37–8.28]), always snored (OR: 3.64 [95% CI: 1.51–9.15]) or often snored (OR: 2.45 [95% CI: 1.04–5.96]), spent more hours per week in daycare (OR per hour/week: 1.03 [95% CI: 1.00–1.05]), had frequent colds (OR: 2.67 [95% CI: 1.59–4.53]), had siblings who had undergone tympanostomy tube placement (OR: 2.68 [95% CI: 1.22–6.02]), underwent long labour (OR: 2.59 [95% CI: 1.03–6.79]), and had early introduction of cow’s milk (OR: 1.76 [95% CI: 1.05–2.97]). Asian ethnicity (OR: 0.20 [95% CI: 0.07–0.53]) and having older siblings (OR: 0.54 [95% CI: 0.31–0.93]) were inversely associated with COME.ConclusionCOME in preschool children was associated with pathogen exposure, respiratory infection, and nasal obstruction. Strategies to prevent pathogen transmission warrant investigation. The novel findings of long labour and early cow’s milk introduction require replication in future studies.

show abstract

Section: Discussionmentioning

confidence: 94%

Determinants of chronic otitis media with effusion in preschool children: a case–control study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Gibbons et al aimed to evaluate a multisystem questionnaire that would help diagnose non-Ig-E-mediated early CMPA and be easy to apply and score in a busy clinical setting. 7 Symptoms for the questionnaire were selected based on chart reviews of patients diagnosed with CMPA and a literature review of its clinical manifestations in infants. Each symptom scores 1 for a positive response, and 0 for a negative response, and an overall score was calculated (see Figure 3).…”

Section: Cmpa Questionnairementioning

confidence: 99%

“…Methodological quality was poor in the risk of bias domains, where all studies scored high risk in at least two domains. Three studies were at high risk in the patient selection domain; two used a case-control study design, 7,8 and one study did not use a consecutive or random sampling method, but instead included only infants that scored a CoMiSS TM of > 12. 23 Three studies demonstrated high risk of index test interpretation bias, due to the lack of pre-specified threshold criterion for a positive screen and a lack of blinding to the results of the reference standard.…”

Section: Development and Piloting Studiesmentioning

confidence: 99%

“…23 Three studies demonstrated high risk of index test interpretation bias, due to the lack of pre-specified threshold criterion for a positive screen and a lack of blinding to the results of the reference standard. 7,23,24 All six studies were at high risk of bias in the reference standard domain because the reference standard DBPCFC was not used, while, one study included the index test in the reference standard. 25 Five studies scored high risk of bias for flow and timing; one left an interval of up to 3 months between applying CoMiSS TM and conducting OFC, 25 two excluded eligible infants from the analysis, 7,23 and two used different reference standards to establish CMPA.…”

Section: Development and Piloting Studiesmentioning

confidence: 99%

“…Moreover, non-IgE-mediated reactions depend on the quantity of exposure and may have a prolonged delay for symptom onset, which may further lead to under diagnosis based on OFC leading to poor nutritional intake, failure to thrive, or worsening eczema. 6,7 NICE guidelines recommend that where CMPA is suspected, an allergy-focused history should be taken before deciding whether and what further tests to perform. 8 Despite this, a lack of awareness of the existing guidelines amongst GPs and inconsistency across the guidelines themselves, leads to uncertainty and variation in diagnosis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A comprehensive evaluation of symptom scores designed to inform the triage and diagnosis of cow’s milk protein allergy in children: a systematic review of the research evidence

Thompson¹,

Zhelev²,

Peters³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Cow's milk protein allergy (CMPA) is an immune-mediated allergic response to proteins in milk, a common infant food allergy. The wide range and frequency of CMPA symptoms make diagnosis a challenge, particularly in primary care. Symptom scores may improve a clinician's awareness of symptoms, thus indicating a need for further testing. This systematic review examined the development and evaluation of such symptom scores for use in infants. Methods: Four databases were searched from inception to 3 December 2019, for diagnostic accuracy studies, randomised controlled trials, observational studies, economic evaluations, qualitative studies, and studies reporting on the development of the tools. Experts were consulted for additional studies. Data were not suitable for meta-analysis due to heterogeneity, so were narratively synthesised. Results: We found two symptom scores evaluated in one and fourteen studies, respectively. Estimated sensitivity and specificity ranged from 37-98% and 38-93%. The evaluations of each tool were at high risk of bias or failed to address issues such as clinical and cost-effectiveness. Conclusions: Estimates of accuracy of symptom scores for CMPA offered so far should be interpreted cautiously. Rigorous research based on well-defined roles for the tools and free of potential conflicts of interest is urgently required. A comprehensive evaluation of symptom scores designed to inform the triage and diagnosis of cow's milk protein allergy in children: a systematic review of the research evidence

show abstract

Faecal calprotectin as an aid to the diagnosis of non-IgE mediated cow's milk protein allergy

Belizón¹,

Páez²,

Claros³

et al. 2016

Anales de Pediatría (English Edition)

View full text Add to dashboard Cite

Non-IgE-Mediated Cow Milk Allergy Is Linked to Early Childhood Clusters of Commonly Seen Illnesses

Abstract: A global evaluation of multiple systems can be an important diagnostic tool in determining CMPA in infants.

Cited by 14 publications

References 29 publications

Determinants of chronic otitis media with effusion in preschool children: a case–control study

Determinants of chronic otitis media with effusion in preschool children: a case–control study

A comprehensive evaluation of symptom scores designed to inform the triage and diagnosis of cow’s milk protein allergy in children: a systematic review of the research evidence

Faecal calprotectin as an aid to the diagnosis of non-IgE mediated cow's milk protein allergy

Contact Info

Product

Resources

About