Constantinide Paula, Trandafir Laura Mihaela, Burlea M
Facultatea de Medicină, Universitatea de Medicină şi Farmacie "Gr.T.Popa" Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2011 Oct-Dec;115(4):1012-7.
Cow's milk allergy affects 8% of infants less than 1 year of age. The allergy is usually transient, with most children tolerating ingested cow'milk by age 3 years. This prospective study analyzes the clinical course, development of tolerance and risk for other atopy (asthma, rhinoconjunctivitis, atopic dermatitis) in children with cow's milk allergy.
We followed 71 infants hospitalized between January 2006 - January 2010 in two clinic of Pediatrics from Iaşi and Galaţi with gastro-intestinal, respiratory and skin signs and symptoms of cow's milk allergy. In this study were identified atopic symptoms and diseases, family history of atopy, measured serum total IgE levels and was evaluated development of tolerance to cow's milk. IgE levels was measured at diagnosis, 12 months after diagnosis and recovery tolerance to cow's milk. Patients were followed to acquire tolerance to cow milk.
The median age of the patients was 7.57 months +/- 2.73DS. IgE-mediated cow's milk allergy was detected in 40.85% (29 cases) of children at diagnosis. After 12 months of follow 7 (24.14%) of 29 cases initially IgE positive became negative. The first rechallenge was carried out 12 months after diagnosis at mean age 1.6 years (95%CI, 1.5-1.6 years) and the result was positive in 12 cases of IgE negative group. All children (100% of cases) with IgE-negative cow'milk allergy were tolerant by 3.0 years old (P < 0.0001) compared to 70.73% in children with positive IgE. In the end 17.24% of patiens with IgE-mediated cow milk allergy presented respiratory and skin atopic sings. Are there significant differences about the persistent cow'milk allergy between the group of children with positive IgE compared to negative IgE. (p = 0.1918, 95% CI).
Most children recover their tolerance to cow milk during childhood and those with negative IgE even at young ages. Patients with positive IgE have an increased risk for allergic diseases, food and inhaled allergens sensitization and development of persistent cow's milk allergy.
牛奶过敏影响8%的1岁以下婴儿。这种过敏通常是短暂的,大多数儿童在3岁时能耐受摄入的牛奶。这项前瞻性研究分析了牛奶过敏儿童的临床病程、耐受性发展以及其他特应性疾病(哮喘、鼻结膜炎、特应性皮炎)的风险。
我们对2006年1月至2010年1月期间在雅西和加拉茨的两家儿科诊所住院的71名婴儿进行了随访,这些婴儿有牛奶过敏的胃肠道、呼吸道和皮肤症状及体征。在这项研究中,确定了特应性症状和疾病、特应性家族史,测量了血清总IgE水平,并评估了对牛奶的耐受性发展。在诊断时、诊断后12个月以及恢复对牛奶的耐受性时测量IgE水平。对患者进行随访以获得对牛奶的耐受性。
患者的中位年龄为7.57个月±2.73标准差。诊断时,40.85%(29例)的儿童检测到IgE介导的牛奶过敏。随访12个月后,最初IgE阳性的29例中有7例(24.14%)变为阴性。首次激发试验在诊断后12个月进行,平均年龄为1.6岁(95%可信区间,1.5 - 1.