Long-term follow-up of fixed low-dose oral immunotherapy for children with severe cow's milk allergy.
Pediatr Allergy Immunol
; 32(4): 734-741, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-33393118
ABSTRACT
BACKGROUND:
The efficacy and safety of cow's milk (CM) low-dose oral immunotherapy (LOIT) at one-year follow-up have been previously reported. We investigated the outcome of fixed long-term LOIT in children with severe CM allergy.METHODS:
Children with positive reactions to oral food challenge (OFC) with 3 mL CM were included. The LOIT group (n = 33) ingested up to 3 mL CM for 1 year. After a two-week CM avoidance, 3 and 25 mL OFCs were performed. Children with positive reactions continued with 3 mL ingestion, with OFCs repeated yearly. Regular home consumption of 25 mL CM after passing the OFCs was defined as 25 mL short-term unresponsiveness (25 mL STU). The historical control group (n = 16) with reactions to 3 mL OFC eliminated daily CM ingestion.RESULTS:
The proportion of 25 mL STU in the LOIT group was 27%, 52%, and 61% after 1, 2, and 3 years, respectively, and the 3-year percentage was significantly higher than that in the historical control group (13%, P = .002). In the LOIT group, only one child developed severe symptoms. Furthermore, in this group, CM- and casein-specific immunoglobulin E (sIgE) levels decreased significantly and casein-specific IgG and IgG4 levels increased significantly after 3 years, whereas the historical control group presented no significant change in these parameters. Baseline sIgE levels were significantly low in children achieving 25 mL STU.CONCLUSION:
Continued fixed LOIT yields immunologic improvement and may be effective and safe for severe CM allergy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Hipersensibilidade a Leite
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Animals
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Child
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Female
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Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article