Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy - 07/08/11
, Nelly Rajuan, MSc c, 
, Michael R. Goldberg, MD, PhD a, Eli Eisenberg, PhD d, Eli Heyman, MD b, Adi Cohen, MD a, Moshe Leshno, MD, PhD eReprint requests: Yitzhak Katz, MD, Institute of Allergy and Immunology, Assaf Harofeh Medical Center, Zerifin, Israel.Abstract |
Background |
The diversity in the perceived prevalence, recovery, and risk factors for cow’s milk allergy (CMA) necessitated a large-scale, population-based prospective study.
Objective |
We sought to determine the prevalence, cross-reactivity with soy allergy, and risk factors for the development of CMA.
Methods |
In a prospective study the feeding history of 13,019 infants was obtained by means of telephone interview (95.8%) or questionnaire (4.2%). Infants with probable adverse reactions to milk were examined, skin prick tested, and challenged orally.
Results |
Ninety-eight percent of the cohort participated in the study. The cumulative incidence for IgE-mediated CMA was 0.5% (66/13,019 patients). The mean age of cow’s milk protein (CMP) introduction was significantly different (P < .001) between the healthy infants (61.6 ± 92.5 days) and those with IgE-mediated CMA (116.1 ± 64.9 days). Only 0.05% of the infants who were started on regular CMP formula within the first 14 days versus 1.75% who were started on formula between the ages of 105 and 194 days had IgE-mediated CMA (P < .001). The odds ratio was 19.3 (95% CI, 6.0-62.1) for development of IgE-mediated CMA among infants with exposure to CMP at the age of 15 days or more (P < .001). Sixty-four patients with IgE-mediated CMA tolerated soy, and none had a proved allergy to soy.
Conclusions |
IgE-mediated CMA is much less common than generally reported. Early exposure to CMP as a supplement to breast-feeding might promote tolerance. Finally, soy is a reasonable feeding alternative in patients with IgE-mediated CMA.
Le texte complet de cet article est disponible en PDF.Key words : IgE-mediated cow’s milk allergy, soy allergy, breast-feeding, skin prick test, oral challenge
Abbreviations used : CMA, CMP, FPIRES, IgE-CMA, OFC, SPT
Plan
| Supported by the Israel Dairy Board. |
|
| Disclosure of potential conflict of interest: Y. Katz has received research support from the Israel Dairy Board. The rest of the authors have declared that they have no conflict of interest. |
Vol 126 - N° 1
P. 77 - juillet 2010 Retour au numéro
Article précédent
- Vitamin D in asthma: Panacea or true promise?
- Adit A. Ginde, E. Rand Sutherland
- Oral peanut immunotherapy in children with peanut anaphylaxis
- Katharina Blumchen, Helen Ulbricht, Ute Staden, Kerstin Dobberstein, John Beschorner, Lucila Camargo Lopes de Oliveira, Wayne G. Shreffler, Hugh A. Sampson, Bodo Niggemann, Ulrich Wahn, Kirsten Beyer
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?