Venter Carina, Brown Trevor, Meyer Rosan, Walsh Joanne, Shah Neil, Nowak-Węgrzyn Anna, Chen Tong-Xin, Fleischer David M, Heine Ralf G, Levin Michael, Vieira Mario C, Fox Adam T
Section of Allergy and Immunology, University of Colorado Denver School of Medicine, Children's Hospital Colorado , Box B518, 13123 East 16th Avenue, Anschutz Medical Campus, Aurora, CO 80045 USA.
Children's Allergy Service, Ulster Hospital, Belfast, BT16 1RH Northern Ireland, UK.
Clin Transl Allergy. 2017 Aug 23;7:26. doi: 10.1186/s13601-017-0162-y. eCollection 2017.
Cow's milk allergy (CMA) is one of the most common presentations of food allergy seen in early childhood. It is also one of the most complex food allergies, being implicated in IgE-mediated food allergy as well as diverse manifestations of non-IgE-mediated food allergy. For example, gastrointestinal CMA may present as food protein induced enteropathy, enterocolitis or proctocolitis. Concerns regarding the early and timely diagnosis of CMA have been highlighted over the years. In response to these, guideline papers from the United Kingdom (UK), Australia, Europe, the Americas and the World Allergy Organisation have been published. The UK guideline, 'Diagnosis and management of non-IgE-mediated cow's milk allergy in infancy-a UK primary care practical guide' was published in this journal in 2013. This Milk Allergy in Primary Care (MAP) guideline outlines in simple algorithmic form, both the varying presentations of cow's milk allergy and also focuses on the practical management of the most common presentation, namely mild-to-moderate non-IgE-mediated allergy. Based on the international uptake of the MAP guideline, it became clear that there was a need for practical guidance beyond the UK. Consequently, this paper presents an international interpretation of the MAP guideline to help practitioners in primary care settings around the world. It incorporates further published UK guidance, feedback from UK healthcare professionals and affected families and, importantly, also international guidance and expertise.
牛奶过敏（CMA）是幼儿期最常见的食物过敏表现之一。它也是最复杂的食物过敏之一，涉及IgE介导的食物过敏以及非IgE介导的食物过敏的多种表现形式。例如，胃肠道CMA可能表现为食物蛋白诱导的肠病、小肠结肠炎或直肠结肠炎。多年来，人们一直强调对CMA进行早期及时诊断的重要性。作为回应，英国、澳大利亚、欧洲、美洲和世界过敏组织都发布了相关指南文件。英国的指南《婴儿期非IgE介导的牛奶过敏的诊断和管理——英国初级保健实用指南》于2013年在本杂志上发表。这份初级保健中的牛奶过敏（MAP）指南以简单的算法形式概述了牛奶过敏的不同表现，并着重于最常见表现形式（即轻度至中度非IgE介导的过敏）的实际管理。基于MAP指南在国际上的应用情况，很明显，除了英国之外，还需要实用的指导。因此，本文对MAP指南进行了国际解读，以帮助世界各地初级保健机构的从业者。它纳入了英国进一步发布的指导意见、英国医疗保健专业人员和受影响家庭的反馈，重要的是，还纳入了国际指导意见和专业知识。
