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Clinical Trial
. 2012 Sep;171(9):1389-95.
doi: 10.1007/s00431-012-1739-z. Epub 2012 May 11.

Specific oral desensitization in children with IgE-mediated cow's milk allergy. Evolution in one year

Montserrat Alvaro  1 , Ma Teresa Giner, Marta Vázquez, Jaime Lozano, Olga Domínguez, Mónica Piquer, Marcia Días, Rosa Jiménez, Ma Anunciación Martín, Laia Alsina, Ana Ma Plaza
Affiliations
Clinical Trial

Specific oral desensitization in children with IgE-mediated cow's milk allergy. Evolution in one year

Montserrat Alvaro et al. Eur J Pediatr. 2012 Sep.

Abstract

Cow's milk allergy is the most frequent childhood food allergy. Children older than 5 who have not become tolerant have less probabilities of natural tolerance. Specific oral desensitization methods are being investigated in reference centres. The aims of our study were to assess the efficacy of our guideline of specific oral desensitization to cow's milk in children and to know its suitability for anaphylactic children. Both clinical and specific IgE outcomes were evaluated. Eighty-seven children aged 5 to 16 years with a history of cow's milk allergy were included. Prior to desensitization, skin prick test, specific IgE to cow's milk proteins and a double-blind placebo control food challenge were performed in all. Of the 87 patients, 21 had a negative challenge; they were considered tolerant, and they were told to follow a free diet. Of the positive, 44 were anaphylactic and 22 non-anaphylactic. All of them were included. In non-anaphylactic patients, 6 achieved partial and 16 maximum desensitization after 23.1 weeks. In the anaphylactic group, 7 achieved partial and 35 maximum desensitization after 26.4 weeks. Cow's milk-specific IgE levels and casein-specific IgE levels were significantly lower in the tolerant patients at baseline. One year after desensitization, the medium specific cow's milk levels and casein IgE levels had dropped significantly.

Conclusions: Our guideline for specific oral desensitization to cow's milk is efficacious even in patients with anaphylactic reactions to cow's milk and represents a significant life change. Immunological changes in 1 year show a drop in cow's milk protein-specific IgE.

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Comment in

  • Milk oral immunotherapy-effective but still experimental.
    Paassilta M, Salmivesi S, Korppi M. Paassilta M, et al. Eur J Pediatr. 2013 Feb;172(2):281. doi: 10.1007/s00431-012-1876-4. Epub 2012 Oct 30. Eur J Pediatr. 2013. PMID: 23108850 No abstract available.
  • Reply to correspondence letter by M. Korppi.
    Álvaro M, Giner MT, Vázquez M, Lozano J, Domínguez O, Piquer M, Días M, Jiménez R, Martín MA, Alsina L, Plaza AM. Álvaro M, et al. Eur J Pediatr. 2013 Feb;172(2):283-4. doi: 10.1007/s00431-012-1877-3. Epub 2012 Nov 1. Eur J Pediatr. 2013. PMID: 23114848 No abstract available.

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