Clinical characteristics, laboratory findings, and tolerance acquisition in infants with cow's milk protein allergy in a private center in Lima, Peru for the period 2021-2022.
Immun Inflamm Dis
; 12(4): e1246, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38668747
ABSTRACT
BACKGROUND:
Cow's milk protein allergy (CMPA) remains relatively understudied in Latin America.METHODS:
In this observational study, we enrolled 64 patients with a median age of 3 months, of whom 60% were male. Patients included had a history of IgE-mediated reactions with IgE sensitization or non-IgE-mediated reactions or symptoms following exposure to cow's milk. They underwent skin prick test, ImmunoCAP, fecal calprotectin (FC), and fecal eosinophil-derived neurotoxin (EDN), in addition to double-blinded placebo-controlled oral food challenges (DBPCFC), with clinical evolution and tolerance acquisition observed over 1 year.RESULTS:
Malnutrition was present in 78.1% of patients, and 87.5% had a family history of atopy, with 51.6% receiving exclusive breastfeeding. Gastrointestinal manifestations were prevalent in 90.6% of patients, followed by dermatological manifestations (10.9%), with only 2 experiencing anaphylaxis. IgE-mediated CMPA was observed in only six patients. In those with non-IgE-mediated CMPA, FC had a median of 284 mg/dL (IQR 138.5-415.5), while EDN had a median of 508.5 mg/dL (IQR 160.25-868). One year after diagnosis, median FC significantly decreased (p < 0.0001), and malnutrition prevalence reduced to 17.1%. Moreover, 81% of patients acquired tolerance following DBPCFC, with 52% utilizing nutritional replacement formulas at diagnosis. Notably, 94% of those extensively hydrolyzed casein-based formulas achieved tolerance (p = 0.08).CONCLUSION:
Our findings provide a foundational framework for future investigations into CMPA diagnosis, tolerance acquisition, and the utilization of hypoallergenic formulas tailored to the unique characteristics of our region.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Inmunoglobulina E
/
Pruebas Cutáneas
/
Hipersensibilidad a la Leche
/
Tolerancia Inmunológica
/
Proteínas de la Leche
Límite:
Animals
/
Female
/
Humans
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Infant
/
Male
País/Región como asunto:
America do sul
/
Peru
Idioma:
En
Revista:
Immun Inflamm Dis
Año:
2024
Tipo del documento:
Article
País de afiliación:
Perú