Businco L, Benincori N, Cantani A
Ann Allergy. 1984 Dec;53(6 Pt 2):615-22.
Clinical manifestations of food allergy (FA) include a large variety of symptoms, most of which are gastrointestinal. Among the various clinical conditions, cow's milk protein allergy (CMPA) usually appears during early infancy; therefore, it is predominantly a problem of childhood. As with any type of FA, the diagnosis of CMPA rests mostly on clinical observation rather than on laboratory tests. Our studies confirm that both skin tests and RAST are valuable tools in the diagnosis. In particular, our follow-up study of a group of infants with CMPA demonstrates that the majority of RAST-positive subjects do not tolerate cow's milk after many years, whereas all RAST-negative infants tolerate cow's milk in their second year of life. Accordingly, RAST may be useful either in the diagnosis or in the prognosis of CMPA. It is generally agreed that treatment of FA should center on avoidance diets. This may not be easy in children with multiple allergies. Prophylactic drugs may be very useful. Disodium cromoglycate, for instance, seems to be effective in the prevention of IgE-mediated FA. They may also be needed when symptoms persist, mostly because of lack of compliance with the antigen avoidance diet. Early prophylaxis against FA appears to be best achieved by breast-feeding. Exclusive breast-feeding should be encouraged for as long as possible when there is a family history of allergy.
食物过敏（FA）的临床表现多种多样，其中大多数为胃肠道症状。在各种临床病症中，牛奶蛋白过敏（CMPA）通常在婴儿早期出现；因此，它主要是一个儿童期问题。与任何类型的食物过敏一样，CMPA的诊断主要基于临床观察而非实验室检查。我们的研究证实，皮肤试验和放射变应原吸附试验（RAST）都是诊断中的重要工具。特别是，我们对一组患有CMPA的婴儿的随访研究表明，大多数RAST阳性的受试者多年后仍不耐受牛奶，而所有RAST阴性的婴儿在其生命的第二年都能耐受牛奶。因此，RAST在CMPA的诊断或预后中可能都有用。人们普遍认为，食物过敏的治疗应以避免饮食为中心。这对于患有多种过敏症的儿童可能并不容易。预防性药物可能非常有用。例如，色甘酸钠似乎对预防IgE介导的食物过敏有效。当症状持续时也可能需要使用，这主要是因为患者未遵守避免抗原饮食。早期预防食物过敏似乎通过母乳喂养能最好地实现。当有过敏家族史时，应尽可能长时间鼓励纯母乳喂养。
