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Real-Life Use of Component-Specific IgE in IgE-Mediated Cow's Milk Protein Allergy in a Spanish Paediatric Allergy Centre.
Cronin, Caoimhe; Muñoz Archidona, Cristina; Fernández Prudencio, Beatriz; Gallagher, Aoife; Velasco Zuniga, Roberto; Trujillo Wurttele, Juan.
Afiliación
  • Cronin C; Department of Paediatrics and Child Health, University College Cork, T12 DC4A Cork, Ireland.
  • Muñoz Archidona C; Irish Centre for Maternal and Child Health Research (INFANT), HRB Clinical Research Facility Cork (CRF-C), Cork University Hospital, T12 DC4A Cork, Ireland.
  • Fernández Prudencio B; Hospital Universitario Severo Ochoa, 28914 Leganes, Spain.
  • Gallagher A; Hospital Universitario de Móstoles, 28935 Madrid, Spain.
  • Velasco Zuniga R; Department of Paediatrics and Child Health, University College Cork, T12 DC4A Cork, Ireland.
  • Trujillo Wurttele J; Irish Centre for Maternal and Child Health Research (INFANT), HRB Clinical Research Facility Cork (CRF-C), Cork University Hospital, T12 DC4A Cork, Ireland.
Antibodies (Basel) ; 12(4)2023 Nov 17.
Article en En | MEDLINE | ID: mdl-37987254
BACKGROUND: In Spain, IgE-mediated cow's milk protein allergy (CMPA) affects approximately 0.69% of infants. Molecular diagnosis may be useful for monitoring natural spontaneous tolerance development in CMPA. The aim of this study was to retrospectively analyse a cohort of paediatric patients with IgE-mediated CMPA who were avoiding milk products awaiting natural tolerance and determine the relationship between disease persistence and major cow's milk allergens. METHODS: A retrospective chart review of 200 patients diagnosed with IgE-mediated CMPA between 2011 and 2020 was conducted. Patients strictly avoided milk products until an oral food challenge was performed. The main outcome was the introduction of liquid milk following a negative oral food challenge and its correlation with IgE and SPT measurements of milk components at diagnosis. Secondary outcomes included the rate of allergic reactions and anaphylaxis during the treatment period and its correlation with IgE and SPT measurements. RESULTS: Of the 200 charts analysed, 122 patients had a negative oral food challenge to milk (61.0%) (95% confidence interval (CI): 54.1-67.5) following a period of strict avoidance of milk. Higher levels of component-specific IgE, especially casein, were associated with failure in the oral food challenge (p = 0.02). Allergic reactions were experienced by 106 children (53%), of which 34 (17%; 95% CI: 12.4-22.8) had anaphylactic reactions. The risk of anaphylaxis was not predicted by raised IgE levels. CONCLUSIONS: While a large proportion of children acquired natural tolerance to cow's milk following a period of strict avoidance, IgE-mediated CMPA persisted in many children. Casein IgE levels at diagnosis were raised in those who failed to achieve natural tolerance. Allergic reactions to milk, including anaphylaxis, occurred commonly, but this was not predicted by raised IgE levels or SPT measurements.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Antibodies (Basel) Año: 2023 Tipo del documento: Article País de afiliación: Irlanda

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Antibodies (Basel) Año: 2023 Tipo del documento: Article País de afiliación: Irlanda