Moneret-Vautrin D A
Department of Intern Medicine, Clinical Immunology and Allergy-Hôpital Central, Nancy.
Allerg Immunol (Paris). 1999 Jun;31(6):201-10.
The prevalence of cow's milk allergy is stable, between 2% and 5%. Clinical symptoms are numerous. Gastroesophageal reflux and persistent constipation have been recently described. The main point is the increasing prevalence of multiple food allergens. Double blind placebo controlled milk challenges are mandatory for the diagnosis, sometimes eight days long. The proof of the IgE-dependent sensitization, or of lymphocyte activation is not always brought. ECP, methylhistamine and tryptase dosages coupled to challenges are not clearly informative tests. The eviction of dairy products is completed by substitution by casein hydrolysates or pork collagen or soy hydrolysates, or by formula made from amino acids. Tolerance protocols are not standardized, however valuable. Review documented by 98 references.
牛奶过敏的患病率稳定在2%至5%之间。临床症状多种多样。最近还描述了胃食管反流和持续性便秘。主要问题是多种食物过敏原的患病率不断上升。诊断必须进行双盲安慰剂对照牛奶激发试验，有时长达八天。并非总能证明存在IgE依赖性致敏或淋巴细胞激活。与激发试验相关的嗜酸性粒细胞阳离子蛋白（ECP）、甲基组胺和类胰蛋白酶检测并非明确有效的检测方法。通过用酪蛋白水解物、猪肉胶原蛋白或大豆水解物替代，或用氨基酸制成的配方奶粉来完成乳制品的排除。耐受方案虽未标准化，但很有价值。文献综述引用了98篇参考文献。
