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Cow's milk protein allergy in children: a practical guide.

Caffarelli C, Baldi F, Bendandi B, Calzone L, Marani M, Pasquinelli P, EWGP - Ital J Pediatr (2010)

Bottom Line: This guide is the result of a consensus reached in the following areas.An overview of acceptable means for diagnosis is included.According to symptoms and infant diet, three different algorithms for diagnosis and follow-up have been suggested.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dipartimento dell'Età Evolutiva, Clinica Pediatrica Università di Parma, Parma, Italy. carlo.caffarelli@unipr.it

ABSTRACT
A joint study group on cow's milk allergy was convened by the Emilia-Romagna Working Group for Paediatric Allergy and by the Emilia-Romagna Working Group for Paediatric Gastroenterology to focus best practice for diagnosis, management and follow-up of cow's milk allergy in children and to offer a common approach for allergologists, gastroenterologists, general paediatricians and primary care physicians.The report prepared by the study group was discussed by members of Working Groups who met three times in Italy. This guide is the result of a consensus reached in the following areas. Cow's milk allergy should be suspected in children who have immediate symptoms such as acute urticaria/angioedema, wheezing, rhinitis, dry cough, vomiting, laryngeal edema, acute asthma with severe respiratory distress, anaphylaxis. Late reactions due to cow's milk allergy are atopic dermatitis, chronic diarrhoea, blood in the stools, iron deficiency anaemia, gastroesophageal reflux disease, constipation, chronic vomiting, colic, poor growth (food refusal), enterocolitis syndrome, protein-losing enteropathy with hypoalbuminemia, eosinophilic oesophagogastroenteropathy. An overview of acceptable means for diagnosis is included. According to symptoms and infant diet, three different algorithms for diagnosis and follow-up have been suggested.

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Immediate and late onset reactions in children with cow's milk protein allergy.
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Figure 1: Immediate and late onset reactions in children with cow's milk protein allergy.

Mentions: A positive atopic familiar history is common in children with suspected CMPA [9]. The diagnosis of CMPA is based on a detailed history of symptoms (Fig. 1), skin prick test and serum specific IgE to cow's milk protein, elimination diet and oral food challenge. Clinical manifestations due to CMPA [6-14] can be divided into IgE-mediated immediate clinical reactions (onset of the symptoms within the 30 minutes after the ingestion of cow's milk) and non IgE-mediated delayed reactions (hours-days after food ingestion), most affecting the skin and the gastrointestinal system. However, immediate and delayed reactions can be associated in atopic eczema and in eosinophilic oesophageal gastroenteritis (Fig. 1).


Cow's milk protein allergy in children: a practical guide.

Caffarelli C, Baldi F, Bendandi B, Calzone L, Marani M, Pasquinelli P, EWGP - Ital J Pediatr (2010)

Immediate and late onset reactions in children with cow's milk protein allergy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823764&req=5

Figure 1: Immediate and late onset reactions in children with cow's milk protein allergy.
Mentions: A positive atopic familiar history is common in children with suspected CMPA [9]. The diagnosis of CMPA is based on a detailed history of symptoms (Fig. 1), skin prick test and serum specific IgE to cow's milk protein, elimination diet and oral food challenge. Clinical manifestations due to CMPA [6-14] can be divided into IgE-mediated immediate clinical reactions (onset of the symptoms within the 30 minutes after the ingestion of cow's milk) and non IgE-mediated delayed reactions (hours-days after food ingestion), most affecting the skin and the gastrointestinal system. However, immediate and delayed reactions can be associated in atopic eczema and in eosinophilic oesophageal gastroenteritis (Fig. 1).

Bottom Line: This guide is the result of a consensus reached in the following areas.An overview of acceptable means for diagnosis is included.According to symptoms and infant diet, three different algorithms for diagnosis and follow-up have been suggested.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dipartimento dell'Età Evolutiva, Clinica Pediatrica Università di Parma, Parma, Italy. carlo.caffarelli@unipr.it

ABSTRACT
A joint study group on cow's milk allergy was convened by the Emilia-Romagna Working Group for Paediatric Allergy and by the Emilia-Romagna Working Group for Paediatric Gastroenterology to focus best practice for diagnosis, management and follow-up of cow's milk allergy in children and to offer a common approach for allergologists, gastroenterologists, general paediatricians and primary care physicians.The report prepared by the study group was discussed by members of Working Groups who met three times in Italy. This guide is the result of a consensus reached in the following areas. Cow's milk allergy should be suspected in children who have immediate symptoms such as acute urticaria/angioedema, wheezing, rhinitis, dry cough, vomiting, laryngeal edema, acute asthma with severe respiratory distress, anaphylaxis. Late reactions due to cow's milk allergy are atopic dermatitis, chronic diarrhoea, blood in the stools, iron deficiency anaemia, gastroesophageal reflux disease, constipation, chronic vomiting, colic, poor growth (food refusal), enterocolitis syndrome, protein-losing enteropathy with hypoalbuminemia, eosinophilic oesophagogastroenteropathy. An overview of acceptable means for diagnosis is included. According to symptoms and infant diet, three different algorithms for diagnosis and follow-up have been suggested.

Show MeSH
Related in: MedlinePlus