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Natural history of cow's milk allergy. An eight-year follow-up study in 115 atopic children.
Eur Rev Med Pharmacol Sci 2004 Jul-Aug; 8(4):153-64ER

Abstract

BACKGROUND

Cow's milk allergy (CMA) is a disease of infancy and usually appears in the first few months of life. The evaluation of infants for possible CMA is one of the more common problems shared by pediatricians. The role of foods in determining and/or aggravating the clinical features of atopic dermatitis (AD) has been stressed in the last decades.

OBJECTIVE

The aim of the present study was to investigate, in children with food related AD, the development of tolerance to the offending food(s), clinical or laboratory data to predict the development of food tolerance, and whether there are clinical or laboratory data to predict the onset of respiratory allergy.

MATERIALS AND METHODS

In this prospective study we report on 115 babies, first examined at a median age of 6 months, and followed-up for 8 years. We have investigated several factors as predictive of the outcome, as follows: early onset; widespread or not-typical (reverse pattern) skin lesions, family history positive for atopy; persisting FA, high levels of total and specific IgE antibodies, association with CMA and asthma.

RESULTS

All these parameters were significantly predictive of a long-term morbidity of AD children with CMA. The median age for tolerance to cow's milk was 7 years + 11 months, to egg 6 years + 6 months, and to wheat 7 years + 2 months. However a great number of both tolerant and intolerant children developed multiple sensitizations. Only 66 children (57%) acquired food tolerance, but there was the onset of asthma in 54% of cases.

CONCLUSION

The natural history of CMA is not well-known, since not many related studies have been done in children. The several predictive factors, all in a negative sense, may be the norm in atopic children. We suggest possible areas of intervention in children at risk due to parental atopy. Preventive measures may induce a dramatic improvement in children with food allergy, but we stress that the long-term prognosis is challenging, since asthma prevalence may increase up to 54% during a long follow-up. Therefore, the natural history of IgE-mediated AD in atopic children sensitized to several allergens may be less optimistic than generally reported.

Authors+Show Affiliations

Department of Pediatrics, University La Sapienza - Rome (Italy).No affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15636401

Citation

Cantani, A, and M Micera. "Natural History of Cow's Milk Allergy. an Eight-year Follow-up Study in 115 Atopic Children." European Review for Medical and Pharmacological Sciences, vol. 8, no. 4, 2004, pp. 153-64.
Cantani A, Micera M. Natural history of cow's milk allergy. An eight-year follow-up study in 115 atopic children. Eur Rev Med Pharmacol Sci. 2004;8(4):153-64.
Cantani, A., & Micera, M. (2004). Natural history of cow's milk allergy. An eight-year follow-up study in 115 atopic children. European Review for Medical and Pharmacological Sciences, 8(4), pp. 153-64.
Cantani A, Micera M. Natural History of Cow's Milk Allergy. an Eight-year Follow-up Study in 115 Atopic Children. Eur Rev Med Pharmacol Sci. 2004;8(4):153-64. PubMed PMID: 15636401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Natural history of cow's milk allergy. An eight-year follow-up study in 115 atopic children. AU - Cantani,A, AU - Micera,M, PY - 2005/1/8/pubmed PY - 2005/2/5/medline PY - 2005/1/8/entrez SP - 153 EP - 64 JF - European review for medical and pharmacological sciences JO - Eur Rev Med Pharmacol Sci VL - 8 IS - 4 N2 - BACKGROUND: Cow's milk allergy (CMA) is a disease of infancy and usually appears in the first few months of life. The evaluation of infants for possible CMA is one of the more common problems shared by pediatricians. The role of foods in determining and/or aggravating the clinical features of atopic dermatitis (AD) has been stressed in the last decades. OBJECTIVE: The aim of the present study was to investigate, in children with food related AD, the development of tolerance to the offending food(s), clinical or laboratory data to predict the development of food tolerance, and whether there are clinical or laboratory data to predict the onset of respiratory allergy. MATERIALS AND METHODS: In this prospective study we report on 115 babies, first examined at a median age of 6 months, and followed-up for 8 years. We have investigated several factors as predictive of the outcome, as follows: early onset; widespread or not-typical (reverse pattern) skin lesions, family history positive for atopy; persisting FA, high levels of total and specific IgE antibodies, association with CMA and asthma. RESULTS: All these parameters were significantly predictive of a long-term morbidity of AD children with CMA. The median age for tolerance to cow's milk was 7 years + 11 months, to egg 6 years + 6 months, and to wheat 7 years + 2 months. However a great number of both tolerant and intolerant children developed multiple sensitizations. Only 66 children (57%) acquired food tolerance, but there was the onset of asthma in 54% of cases. CONCLUSION: The natural history of CMA is not well-known, since not many related studies have been done in children. The several predictive factors, all in a negative sense, may be the norm in atopic children. We suggest possible areas of intervention in children at risk due to parental atopy. Preventive measures may induce a dramatic improvement in children with food allergy, but we stress that the long-term prognosis is challenging, since asthma prevalence may increase up to 54% during a long follow-up. Therefore, the natural history of IgE-mediated AD in atopic children sensitized to several allergens may be less optimistic than generally reported. SN - 1128-3602 UR - https://www.unboundmedicine.com/medline/citation/15636401/Natural_history_of_cow's_milk_allergy__An_eight_year_follow_up_study_in_115_atopic_children_ DB - PRIME DP - Unbound Medicine ER -