Kanny G, Moneret-Vautrin D A, Flabbee J, Hatahet R, Virion J M, Morisset M, Guenard L
Immunologie Clinique et Allergologie, Hôpital Central, Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy.
Allerg Immunol (Paris). 2002 Mar;34(3):82-4.
Food allergy to cow's milk proteins (APLV) is frequently found in young infants. Treatment is by starting an elimination diet. Different substitution products have been proposed: soya milk, partial hydrolysate of the proteins of lactoserum, powdered casein hydrolysate, hydrolysed soya and pork collagen. Allergic reactions to soya milk, hydrolysates of lactoserum proteins, powdered casein hydrolysates and hydrolysates of soya have been described. The study that we present evaluates the effect on the natural development of these allergies of a formula based on amino-acids (Neocate) in 26 patients who presented a syndrome of multiple allergies one of which was a food allergy to milk. Twenty-five of them had a severe atopic dermatitis, isolated (14 cases), or associated with gastro-intestinal troubles (6) break in the growth curve (5), anaphylactic reactions (2), one asthma (1). One child had a chronic diarrhoea associated with a weight plateau. Evaluation 2 or 3 months later showed a significant improvement of the atopic dermatitis. Return of the stature-weight growth was noted in 4 children from 5, the check in one was reported as due to a initially unrecognised allergy to gluten. The recovery of the APLV was shown by double-blind oral provocation test in 20/23 children between 11 and 37 months (22 +/- 9). Duration of administration of Neonate was between 6 to 19 months (12 + 5) months. This study confirmed the beneficial effect of the amino-acid formula on weight gain, gastro-intestinal troubles and development of atopic dermatitis. The level of recovery of APLV of 86% at the age of 2 years is better than that reported in the syndrome of multiple food allergies of 22%. The influence of this diet on the development of other food allergies remains to be evaluated.
牛奶蛋白食物过敏(APLV)在幼儿中很常见。治疗方法是开始采用排除饮食法。人们提出了不同的替代产品:豆浆、乳清蛋白部分水解物、酪蛋白水解物粉末、水解大豆和猪肉胶原蛋白。已有对豆浆、乳清蛋白水解物、酪蛋白水解物粉末和大豆水解物的过敏反应的描述。我们开展的这项研究评估了一种基于氨基酸的配方奶粉(纽康特)对26例患有多种过敏综合征(其中之一为牛奶食物过敏)患者过敏自然发展情况的影响。其中25例患有重度特应性皮炎,单独出现(14例),或伴有胃肠道问题(6例)、生长曲线中断(5例)、过敏反应(2例)、1例哮喘(1例)。1名儿童患有慢性腹泻并伴有体重停滞。2至3个月后的评估显示特应性皮炎有显著改善。5名儿童中有4名恢复了身高体重增长,1名儿童的检查结果显示是由于最初未识别出的麸质过敏。20/23名11至37个月(22±9)的儿童通过双盲口服激发试验显示牛奶蛋白食物过敏得到恢复。纽康特的服用时间为6至19个月(12±5个月)。这项研究证实了氨基酸配方奶粉对体重增加、胃肠道问题和特应性皮炎发展具有有益作用。2岁时牛奶蛋白食物过敏的恢复率为86%,优于多种食物过敏综合征中报道的22%。这种饮食对其他食物过敏发展的影响仍有待评估。