Oral desensitization is a promising therapeutic approach in patients with persistent and severe cow’s milk allergy (CMA). In this report we aimed to evaluate relationship between the oral desensitization results and serum casein spIgE levels in CMA.
Methods:
Oral desensitization was performed with semirush protocol in 20 children with persistent CMA aged 3-8 years. Clinical symptoms, tolerated milk amount, SPT results, spIgE levels, results of oral food challenges and levels of milk proteins were evaluated at the beginning and 6 months later.
Results:
There were 17 boys and 3 girls with the mean age of 5.0±1.41 years. Atopic dermatitis was diagnosed in 15 children (75%), asthma in 12(60%), GIS symptoms, rhinitis and anaphylaxis in 5,3 and 3; respectively(25%.15%,15%). Mean serum milk spIgE level was 124 ±290 KuA/L(Median;25,8)KuA/L, casein spIgE level;32,25 ±31,01 KuA/L, a-lactalbumin;16,69±34,21(Median:4,62)KuA/L and ß-lactoglobulin;10,36 ±20,74(Median;2,38)KuA/L. Oral desensitization completed successfully in 17 children whereas failed in 3 patients because of anaphylactic reaction. Seventeen children could tolerate 30-200ml undiluted milk after 6 months. We found statistically negative correlation between the casein spIgE levels and tolerated milk amounts (r:-0,380,p:0.043), however there were no significant correlation between the tolerated milk amounts and total milk spIgE levels(r:-0,271,p:0.15), a-lactalbumin (r:-0,329,p:0,096) and ß-lactoglobulin (r:-0,35,p:0,079)
Conclusions:
Casein is an important predicting component for the persistent and severe CMA. In this report we showed that casein spIgE levels can be used for predictor of oral desensitization success in children with CMA.