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[Diagnosis and management of cow's protein milk allergy in infant].
Tunis Med. 2015 Apr; 93(4):205-11.TM

Abstract

BACKGROUND

Cow's milk protein allergy (CMPA) can be responsible of a variety of symptoms and can be caused by IgE or non-IgEmediated reactions. The remaining questions concern the diagnosis (what are the most suggestive clinical manifestations, the laboratory evaluations which play a supporting role, and the management of CMPA in breast fed infants and formula-fed infants.

METHODS

Review of the pub med, science direct, Cochrane library, using the key words cow's milk protein allergy, guideline, and child. Evidence was levelled A, B, C.

RESULTS

No symptom is pathognomonic. A thorough history and careful clinical examination are necessary to suspect the disease. Skin prick tests, and serum specific IgE are only indicative of sensitivation to CMP. A double-blind placebo-controlled challenge is considered the gold standard in diagnosis, but in practice only an open challenge is performed. The patient with suspected pathology will follow a cow's milk free diet for 2-4 weeks. Formula-fed infants get an extensively hydrolyzed formula .If the allergy is present, clinical manifestations will disappear. If symptoms do not improve, an amino acid based formula should be considered. In severe Cow's milk protein allergy with life-threatening symptoms, an amino-acid formula is recommended. The infant should be maintained on an elimination diet until the infant is between 9-12 months or at least for 6 months. The overall natural evolution of the disease is favorable with most patients achieving tolerance to milk by the age of five years.

CONCLUSION

The importance of defined diagnostic criteria needs to be emphasized. It precludes infants from an unnecessary diet and avoids delay in diagnosis, which can lead to malnutrition.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

fre

PubMed ID

26375735

Citation

Mazigh, Sonia, et al. "[Diagnosis and Management of Cow's Protein Milk Allergy in Infant]." La Tunisie Medicale, vol. 93, no. 4, 2015, pp. 205-11.
Mazigh S, Yahiaoui S, Ben Rabeh R, et al. [Diagnosis and management of cow's protein milk allergy in infant]. Tunis Med. 2015;93(4):205-11.
Mazigh, S., Yahiaoui, S., Ben Rabeh, R., Fetni, I., & Sammoud, A. (2015). [Diagnosis and management of cow's protein milk allergy in infant]. La Tunisie Medicale, 93(4), 205-11.
Mazigh S, et al. [Diagnosis and Management of Cow's Protein Milk Allergy in Infant]. Tunis Med. 2015;93(4):205-11. PubMed PMID: 26375735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnosis and management of cow's protein milk allergy in infant]. AU - Mazigh,Sonia, AU - Yahiaoui,Salem, AU - Ben Rabeh,Rania, AU - Fetni,Ilhem, AU - Sammoud,Azza, PY - 2015/9/17/entrez PY - 2015/9/17/pubmed PY - 2015/12/15/medline SP - 205 EP - 11 JF - La Tunisie medicale JO - Tunis Med VL - 93 IS - 4 N2 - BACKGROUND: Cow's milk protein allergy (CMPA) can be responsible of a variety of symptoms and can be caused by IgE or non-IgEmediated reactions. The remaining questions concern the diagnosis (what are the most suggestive clinical manifestations, the laboratory evaluations which play a supporting role, and the management of CMPA in breast fed infants and formula-fed infants. METHODS: Review of the pub med, science direct, Cochrane library, using the key words cow's milk protein allergy, guideline, and child. Evidence was levelled A, B, C. RESULTS: No symptom is pathognomonic. A thorough history and careful clinical examination are necessary to suspect the disease. Skin prick tests, and serum specific IgE are only indicative of sensitivation to CMP. A double-blind placebo-controlled challenge is considered the gold standard in diagnosis, but in practice only an open challenge is performed. The patient with suspected pathology will follow a cow's milk free diet for 2-4 weeks. Formula-fed infants get an extensively hydrolyzed formula .If the allergy is present, clinical manifestations will disappear. If symptoms do not improve, an amino acid based formula should be considered. In severe Cow's milk protein allergy with life-threatening symptoms, an amino-acid formula is recommended. The infant should be maintained on an elimination diet until the infant is between 9-12 months or at least for 6 months. The overall natural evolution of the disease is favorable with most patients achieving tolerance to milk by the age of five years. CONCLUSION: The importance of defined diagnostic criteria needs to be emphasized. It precludes infants from an unnecessary diet and avoids delay in diagnosis, which can lead to malnutrition. SN - 0041-4131 UR - https://www.unboundmedicine.com/medline/citation/26375735/[Diagnosis_and_management_of_cow's_protein_milk_allergy_in_infant]_ L2 - http://www.latunisiemedicale.com/article-medicale-tunisie.php?article=2773 DB - PRIME DP - Unbound Medicine ER -