Correlation of clinical symptoms and laboratory findings in children with milk allergy.

ABSTRACT

Food hypersensitivities can be divided into toxic and nontoxic, and the latter can further be subdivided into immune and nonimmune hypersensitivities. Cow's milk allergy or intolerance occurs in 5-15% of infants, mostly during the first year of life, or occasionally later. The symptoms may involve different organ systems, especially the gastrointestinal system, skin, and respiratory system. For the diagnosis of cow's milk protein allergy/intolerance, double-blind, placebo-controlled food challenge has been used as a gold standard. Since the test suffers from some drawbacks, many reports have pointed to the need for novel and simpler diagnostic procedures and criteria. In our study, clinical symptoms and laboratory findings of patients with cow's milk protein allergy were compared to assess the possible correlation between particular laboratory findings, clinical picture, and the organ system predominantly involved. There were no significant differences in the levels of IgE, cow's milk protein specific IgE, eosinophilia, prick test results, rectal mucosa biopsy histology, and atopy incidence in patient families among the children with gastrointestinal, cutaneous, and combined gastrointestinal and cutaneous symptoms. Improvement in the symptoms with dietary therapy irrespective of clinical presentation and type of hypersensitivity underlying the symptoms in all these patients strongly suggests that clinical response should be a basic criterion for the diagnosis of cow's milk protein allergy.