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Inicio Allergologia et Immunopathologia The efficiency of the symptom-based score in infants diagnosed with cow's mi...
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Vol. 47. Issue 3.
Pages 265-271 (May - June 2019)
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Vol. 47. Issue 3.
Pages 265-271 (May - June 2019)
Original Article
DOI: 10.1016/j.aller.2018.09.006
The efficiency of the symptom-based score in infants diagnosed with cow's milk protein and hen's egg allergy
Seda Sirin Kose
Corresponding author

Corresponding author.
, G. Atakul, S. Asilsoy, N. Uzuner, O. Anal, O. Karaman
Dokuz Eylul University, Division of Pediatric Immunology and Allergy, Izmir, Turkey
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Tables (5)
Table 1. Symptom-based score.9
Table 2. Comparison of IgE-mediated, non-IgE-mediated and mixed type allergic reaction groups.
Table 3. Comparison of cow's milk protein (CMPA), hen's egg (HEA) and cow's milk protein and hen's egg (CMPHEA) allergy groups.
Table 4. Evaluation of the decrease in SBS after elimination diet.
Table 5. Cut-off values of SBS.
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Introduction and objectives

Symptom-based score (SBS) quantifies the number and severity of suspected cow's milk-related symptoms. In this study, we aimed to evaluate the efficiency of SBS in patients diagnosed with cow's milk protein (CMPA) and hen's egg allergy (HEA).

Materials and methods

A single-center study was conducted between June 2015 and August 2017. Infants who were diagnosed with CMPA and HEA or both were enrolled in the study. SBS was applied at baseline and at one month during an elimination diet.


One hundred and twelve patients were enrolled in the study. Of these, 56 (50%) were female. Forty-nine (43.8%) patients were diagnosed with CMPA, 39 (34.8%) patients were diagnosed with HEA and 24 (21.4%) patients were diagnosed with cow's milk protein and hen's egg allergy (CMPHEA).

In the analysis of SBS, median Bristol scale and initial total symptom-based scores were significantly lower in the HEA group than others (p=0.002; p=0.025). After the elimination diet, mean SBS decrease in the CMPHEA group (11.3±4.7) was found to be higher than CMPA (8.8±3.7) and HEA (8.0±4.0) groups (p=0.009). In 41 (83.7%) patients with CMPA, 33 (84.6%) patients with HEA and 21 (87.5%) patients with CMPHEA, a ≥50% decrease in SBS was observed after the elimination diet.


We may conclude that the present study suggests that SBS can be useful in monitoring the response to elimination diet in infants diagnosed with cow's milk protein and hen's egg allergy.

Cow's milk protein
Hen's egg
Symptom-based score


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