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[Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein].
Rev Chil Pediatr. 2016 Nov - Dec; 87(6):449-454.RC

Abstract

INTRODUCTION

Cow's milk protein allergy (CMPA) is highly prevalent in infants (2-5%). It has a wide clinical spectrum, and confirmation through an oral food challenge (OFC) is relevant for its differential diagnosis. Information on this topic is scarce in Chile.

OBJECTIVE

To describe the demographic and clinical features of infants with suspected CMPA.

PATIENTS AND METHOD

A retrospective study of patients<1 year-old, treated for suspected CMPA between 2009 and 2011. Demographic data, symptoms of atopy, nutrition at the time of diagnosis, CMPA symptoms, diagnostic studies, and response to treatment were recorded. Diet response at least 4 weeks after milk modification, and clinical behavior when suspected foods were added back to the diet were considered standard diagnostic criteria. Descriptive statistics were performed using Epiinfo ™ software.

RESULTS

The study included 106 infants, of whom, 51% male, 80% term newborns, 74% with≥1 atopic parent, and 34% with ≥1 parent/sibling with food allergy. The median age at onset of symptoms was 1.5 months (range 1.5-2m). Almost half (46%) were breast-feeding≥6m, with 15% receiving formula milk since the neonatal period, and 49% before the third month. Common symptoms were: vomiting (63%), colic (49%), and bleeding on passing stools (41%). No anaphylaxis was identified, and 61% had≥2 symptoms at debut. Only 34% were subjected to OFC. The most frequently requested tests were, test patch (43%), prick test (40%), and blood in stools (37%).

TREATMENT

43% breast feeding with exclusion diet, 24% extensively hydrolysed formula, 26% amino acid formula, and 7% others.

CONCLUSION

Demographic characteristics and risk factors were similar to those previously described in international literature. Clinical presentation was early in life, and digestive symptoms predominated. OFC was underused for diagnosis, and most of the tests requested did not change management.

Links

Publisher Full Text
linkinghub.elsevier.com
scielo.cl

Authors+Show Affiliations

Errázuriz G
Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile. Electronic address: gerrazuriz@clc.cl.
Lucero Y
Unidad de Gastroenterología, Departamento de Pediatría y Cirugía Infantil Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Ceresa S
Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
Gonzalez M
Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
Rossel M
Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
Vives A
Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.

MeSH

Breast FeedingChileColicFemaleGastrointestinal HemorrhageHumansInfantInfant, NewbornMaleMilk HypersensitivityMilk ProteinsPrevalenceRetrospective StudiesRisk FactorsVomiting

Pub Type(s)

Journal Article

Language

spa

PubMed ID

27634007

Citation

Errázuriz, Germán, et al. "[Clinical Characteristics and Management of Infants Less Than 1-year-old Suspected With Allergy to Cow's Milk Protein]." Revista Chilena De Pediatria, vol. 87, no. 6, 2016, pp. 449-454.
Errázuriz G, Lucero Y, Ceresa S, et al. [Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein]. Rev Chil Pediatr. 2016;87(6):449-454.
Errázuriz, G., Lucero, Y., Ceresa, S., Gonzalez, M., Rossel, M., & Vives, A. (2016). [Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein]. Revista Chilena De Pediatria, 87(6), 449-454. https://doi.org/10.1016/j.rchipe.2016.06.007
Errázuriz G, et al. [Clinical Characteristics and Management of Infants Less Than 1-year-old Suspected With Allergy to Cow's Milk Protein]. Rev Chil Pediatr. 2016;87(6):449-454. PubMed PMID: 27634007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein]. AU - Errázuriz,Germán, AU - Lucero,Yalda, AU - Ceresa,Sergio, AU - Gonzalez,Mónica, AU - Rossel,Maureen, AU - Vives,Andrés, Y1 - 2016/09/12/ PY - 2015/02/26/received PY - 2016/06/08/revised PY - 2016/06/21/accepted PY - 2016/9/17/pubmed PY - 2017/4/11/medline PY - 2016/9/17/entrez KW - Alergia a proteína de leche de vaca KW - Alergia alimentaria KW - Allergic proctocolitis KW - Colic KW - Cow's milk allergy KW - Cólico KW - Food allergy KW - Gastroesophageal reflux disease KW - Proctocolitis alérgica KW - Reflujo gastroesofágico patológico SP - 449 EP - 454 JF - Revista chilena de pediatria JO - Rev Chil Pediatr VL - 87 IS - 6 N2 - INTRODUCTION: Cow's milk protein allergy (CMPA) is highly prevalent in infants (2-5%). It has a wide clinical spectrum, and confirmation through an oral food challenge (OFC) is relevant for its differential diagnosis. Information on this topic is scarce in Chile. OBJECTIVE: To describe the demographic and clinical features of infants with suspected CMPA. PATIENTS AND METHOD: A retrospective study of patients<1 year-old, treated for suspected CMPA between 2009 and 2011. Demographic data, symptoms of atopy, nutrition at the time of diagnosis, CMPA symptoms, diagnostic studies, and response to treatment were recorded. Diet response at least 4 weeks after milk modification, and clinical behavior when suspected foods were added back to the diet were considered standard diagnostic criteria. Descriptive statistics were performed using Epiinfo ™ software. RESULTS: The study included 106 infants, of whom, 51% male, 80% term newborns, 74% with≥1 atopic parent, and 34% with ≥1 parent/sibling with food allergy. The median age at onset of symptoms was 1.5 months (range 1.5-2m). Almost half (46%) were breast-feeding≥6m, with 15% receiving formula milk since the neonatal period, and 49% before the third month. Common symptoms were: vomiting (63%), colic (49%), and bleeding on passing stools (41%). No anaphylaxis was identified, and 61% had≥2 symptoms at debut. Only 34% were subjected to OFC. The most frequently requested tests were, test patch (43%), prick test (40%), and blood in stools (37%). TREATMENT: 43% breast feeding with exclusion diet, 24% extensively hydrolysed formula, 26% amino acid formula, and 7% others. CONCLUSION: Demographic characteristics and risk factors were similar to those previously described in international literature. Clinical presentation was early in life, and digestive symptoms predominated. OFC was underused for diagnosis, and most of the tests requested did not change management. SN - 0717-6228 UR - https://www.unboundmedicine.com/medline/citation/27634007/[Clinical_characteristics_and_management_of_infants_less_than_1_year_old_suspected_with_allergy_to_cow's_milk_protein]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0370-4106(16)30073-0 DB - PRIME DP - Unbound Medicine ER -