Specific oral tolerance induction in children with very severe cow's milk-induced reactions
- PMID: 18158176
- DOI: 10.1016/j.jaci.2007.10.029
Specific oral tolerance induction in children with very severe cow's milk-induced reactions
Abstract
Background: Some children allergic to cow's milk proteins (CMPs) experience exceptionally severe reactions after ingesting only trace amounts of antigen. Avoiding the food and carrying self-injectable epinephrine are the current strategies for their management.
Objective: The aim of this study was to evaluate the safety and efficacy of specific oral tolerance induction (SOTI) for children with severe CMP-induced systemic reactions.
Methods: Ninety-seven children aged 5 years or older with a history of severe allergic reactions and very high CMP-specific IgE levels were selected for a double-blind, placebo-controlled food challenge. Sixty had positive test results to very small amounts of milk and were randomly divided in 2 different groups. Thirty children (group A) immediately began SOTI, whereas the remaining 30 (group B) were kept on a milk-free diet and followed for 1 year.
Results: After 1 year, 11 (36%) of 30 children in group A had become completely tolerant, 16 (54%) could take limited amounts of milk (5-150 mL), and 3 (10%) were not able to complete the protocol because of persistent respiratory or abdominal complaints. In group B the result of the double-blind, placebo-controlled food challenge performed after a year was positive in all 30 cases (P < .001).
Conclusions: In this study SOTI was effective in a significant percentage of cases.
Comment in
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Food-specific immunotherapy: past, present, and future.J Allergy Clin Immunol. 2008 Feb;121(2):336-7. doi: 10.1016/j.jaci.2007.11.035. Epub 2008 Jan 7. J Allergy Clin Immunol. 2008. PMID: 18179815 No abstract available.
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Specific oral tolerance induction increased tolerance to milk in children with severe cow's milk allergy.Evid Based Med. 2009 Apr;14(2):50. doi: 10.1136/ebm.14.2.50. Evid Based Med. 2009. PMID: 19332606 No abstract available.
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