Cow's milk allergy (CMA) is the most common food allergy. Clinical manifestations are mediated immediate hypersensitivity and delayed. The allergy study include: specific IgE, prick and patch test. Regarding treatment, this is based on the exclusion diet and the replacement of cow's milk hydrolysates extensive.
Virtually all infants who have cow's milk allergy develop this condition in the first year of life, with clinical tolerance developing in about 80 percent by their fifth birthday.
Methods:
Describe the case of a child with CMA, which moves without tolerance and also become sensitized to other foods
Results:
Female with 6 years of age. At 9 months presents watery diarrhea,weight loss and intermittent rash.
Initial study (2006): Upper endoscopy: Duodenitis chronic nonspecific, total IgE: 72.60 IU / ml, IgE specific to cow's milk 10.40 IU / ml (Class III) and prick test positive.
Exclusion diet starts to cow's milk, its derivatives and beef. Patient improvement.
At 2 years, begins with rhinitis and diarrhea reappears with low weight.Colonoscopy (2007): Subacute nonspecific colitis histology.
At 3 years old facial angioedema, throat and rash are associated with eating chicken, turkey, carrot and orange juice.
New tests: specific IgE cow's milk, 24. 7Ul/ml (Class IV), class II chicken. Prick test positive.
At 4 years enter kindergarten, restarts with diarrhea and occasional angioedema.
Cow's milk specific IgE (January 2009): 66, 6 IU /ml (class V).
January 2010: 5 years post anaphylactic shock milk pudding. Besides diarrhea 10 times a day, intermittently throughout the year.
Year 2011: intermittent diarrhea and specific IgE to cow's milk is kept in class V
Conclusions:
In this case the patient with CMA, which evolved atypically because it has not been able to acquire tolerance. Moreover, awareness is added to other foods during their evolution.
Recent study, indicated a lower rate of development of clinical tolerance. As assessed by passing a milk challenge, 5 percent were tolerant at age 4 and 21 percent at age 8. Patients with persistent milk allergy have higher cow’s milk sIgE levels in the first 2 years of life.Approximately 35 percent developed allergy to other foods.