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Vol. 47. Issue 4.
Pages 322-327 (July - August 2019)
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Vol. 47. Issue 4.
Pages 322-327 (July - August 2019)
Original Article
DOI: 10.1016/j.aller.2018.10.005
Yogurt is tolerated by the majority of children with IgE-mediated cow's milk allergy
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S. Monacoa, G. Russoa, A. Romanoa, L. Liottib, M.C. Vergac, S. Miceli Sopoa,
Corresponding author
a Allergy Unit, Pediatrics Area, Department of Woman and Child Health, Policlinico Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, Rome, Italy
b Allergy Unit, Pediatric Clinic, Civil Hospital, Senigallia, Italy
c Primary Care Pediatrics, ASL Salerno, Italy
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Tables (3)
Table 1. Results concerning prick by prick, oral food challenge and rub test with cow's milk.
Table 2. Results concerning prick by prick, oral food challenge and rub test with yogurt.
Table 3. OFC with other forms of processed CM.
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Abstract
Background

Children with IgE-mediated cow's milk allergy (IgE-CMA) with gastrointestinal symptoms tolerate yogurt at 100%. Yogurt tolerance in children with IgE-CMA with urticaria and anaphylaxis was 7%.

Methods

We enrolled children with IgE-CMA with cutaneous, respiratory, gastrointestinal and anaphylactic symptoms. All performed prick by prick (PbP) and oral food challenge (OFC) with yogurt. Some children performed also an OFC with CM mixed with wheat flour and baked, baked liquid CM, parmesan.

Results

34 children were enrolled, 31/34 (91%) with systemic adverse reaction after ingestion of CM (systemic CMA), 3/34 (9%) with isolated contact urticaria (ICU CMA). PbP with yogurt was negative only in one patient. OFC with yogurt was passed (that is, the OFC was negative) by 20/31 (64%) of the children with systemic CMA. 10/11 (91%) of the patients who failed OFC (that is, the OFC was positive) with yogurt were positive to SPT with casein vs. 8/20 (40%) of the patients who passed it (p=0.018). None of the 19 children who passed OFC with yogurt failed all OFC with processed CM forms other than yogurt that tested vs. 4/8 among those who failed OFC with yogurt (p=0.006). The rub test with yogurt was negative in 1/3 (33%) of the patients with ICU CMA.

Conclusions

The results of our study are placed alongside others already present in the literature and concerning other methods of processing CM proteins and help to reduce the dietary restrictions of the majority of children with systemic IgE-CMA.

Keywords:
Cow's milk allergy
Yogurt
Oral food challenge
Tolerance
Abbreviations:
BLG
IgE-CMA
ICU CMA
OFC
PbP
SPT

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