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Objective: Cow’s milk (CM) contains some proteins capable of causing an allergic reaction in a sensitized individual and one of the most common causes of food allergy in childhood. Most of the patients will develop tolerance by the age of 3. In this study, we aimed to evaluate sensitivity to CM allergen components as well as goat’s milk (GM) and sheep’s milk cross reactions in cow’s milk allergic (CMA) patients and to figure out the risk factors for tolerance non-development. Methods: This is a retrospective cross-sectional study including 66 patients for IgE-mediated CMA with mean age of 38 months. We evaluated the patients in two groups: Group 1 (n=50): Patients who have no tolerance in oral food challenge test; Group 2 (n= 16): Patients who were found tolerant to CM after elimination diet. Cow’s milk-spesific IgE(sIgE), α-lactalbumin(ALA)-sIgE, β-Lactoglobulin(BLG)-sIgE, casein-sIgE, goat's milk-sIgE, sheep's milk-sIgE, skin prick tests(SPTs) with CM and GM, eosinophils in peripheral blood were all compared between two groups. Results: In the whole group, goat's milk-sIgE and sheep's milk-sIgE were positive in 84.8% and ALA-sIgE, BLG-sIgE, casein-sIgE were positive in 69.7%, 62.7%, 77.3% of the patients, respectively. Two groups were similar in terms of age at onset and diagnosis, gender, median elimination period, total IgE levels, cow’s milk-sIgE and eosinophilia (p>0.05). Mean wheal diameters of CM and GM in SPT (p<0.001), goat's milk-sIgE (p=0.03), sheep's milk-sIgE (p=0.01) were significantly higher in Group 1. Cow’s milk-sIgE showed a positive correlation with total IgE (p=0.001), eosinophilia percentage (p=0.04), CM wheal diameter in SPT (p=0.001), casein-sIgE (p<0.001), goat's milk-sIgE (p<0.001), sheep's milk-sIgE (p<0.001) in Group 1. Patients with respiratory symptoms and history of anaphylaxis had higher cow’s milk-SPT, cow’s milk-sIgE, casein-sIgE, goat's milk-sIgE, sheep's milk-sIgE levels(p<0.05). Gastrointestinal and skin symptoms showed no relation with laboratory findings. Any patient with a history of anaphylaxis did not develop tolerance. Conclusions: As with cow’s milk-sIgE levels and high induration diameters in SPT; high casein-sIgE, sheep's milk-sIgE and goat's milk-sIgE levels are also risk factors for persistence of CMA. Anaphylaxis, as a first reaction, may also be a risk factor. High cow’s milk-sIgE, casein-sIgE, sheep's milk-sIgE, goat's milk-sIgE levels are associated with respiratory symptoms.
Goal: Beef milk (IS) contains some proteins that can lead to allergic reactions in sensitive individuals and is one of the most common causes of food allergies in childhood. Many patients develop tolerance until the age of 3. This study was aimed at evaluating cow’s milk and cow’s milk cross-reactions, along with the sensitivity to cow’s milk allergies (α-lactalbumin, β-lactoglobulin, kazein), and the impact on the development of clinical findings and tolerance. Method: This study was a retrospective cutting study with an average of 38 months of 66 patients followed by the diagnosis of ISA through IgE, and the patients were evaluated in two groups; Group 1(n=50): Patients found not to develop tolerance according to the nutritional load test (BYT), Group 2(n=16): Patients found to develop tolerance in the elimination diet and BYT test. Among the two groups, cow’s milk(IS)-sIgE, α-laktalbumin(A-LA)-sIgE, β-Laktoglobulin(BLG)-sIgE, kazein(CAS)-sIgE, cow’s milk(KS)-sIgE and cow’s milk(KoS)-sIgE, skin prick test(DPT) IS and KS were compared with the foam diameter, the peripheral blood eosinofil percentage. Discussions: High CAS-sIgE, KS-sIgE, KoS-sIgE levels persistent is a risk factor such as IS-sIgE levels for ISA and the elevation of the IS foam diameter in DPT. The first reaction is considered an anaphylaxis as a risk factor. High IS-sIgE, CAS-sIgE, KS-sIgE, KoS-sIgE levels are associated with respiratory findings. (SETB-2020-09-180) Results: in 84.8% of patients, KS-sIgE and KoS-sIgE sensitivity was identified; the A-LA-sIgE, bLG-sIgE, CAS-sIgE sensitivity was respectively 69.7%, 62.7%, 77.3%. Between the groups, there was no difference between the start and diagnosis of ISA by age, gender, average elimination time, Total IgE, IS-sIgE, A-LA-sIgE, bLG-sIgE, eozinofil percentage (p>0.05). In Group 1 DPT with IS and KS, the gap diameter (p<0.001), CAS-sIgE (p<0.001), KS-sIgE (p=0.003), KoS-sIgE (p=0.001) were higher. with IS-sIgE total IgE(p=0.001), % eozinofil(p=0.04), the diameter of foam with IS in DPT (p=0.001), CAS-sIgE (p<0.001), KS-sIgE (p<0.001), KoS-sIgE (p<0). A positive correlation between 001 was found. Patients with respiratory symptoms and anaphylactic history had high levels of IS-DPT, IS-sIgE, CAS-sIgE, KS-sIgE, KoS-sIgE (p<0.05); no relationship between gastrointestinal findings or skin symptoms and laboratory findings was found. No patient with anaphylactic history was tolerated.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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