Caracteristicile clinico-paraclinice şi evoluţia copiilor cu alergie la proteinele din laptele de vacă: date din ambulatoriu

Abstract

Cow’s milk protein allergy (CMPA) occurs in breastfed/ar­ti­fi­cially fed infants, and the early diagnosis and the diet reduce the somatic impairment risk. Objectives. A pros­pective study was conducted, evaluating the clinical and paraclinical characteristics and the evolution of CMPA in children, the medical consults (pediatrics and other) and the severe manifestations. Materials and method. Forty-one patients with allergologically confirmed CMPA were fol­lowed for five years, divided into two groups: breast­fed versus formula/mixed fed. Outcomes. Group 1 in­clu­ded 24 patients (58.5%). There were similar clinical and pa­ra­cli­ni­cal parameters between groups, except for initial weight percentile (49 versus 30.6; p=0.04). Twenty-three pa­tients (56.1%) had multiple food allergies, 14 of them (60.8%) with egg white allergy. The pediatric reevaluations were associated with IgE to CMP (p=0.02), weight gain with initial percentile (p=0.04), and with family history of al­ler­gies (p=0.01). Weight percentile decreased by more than 10% in 17 children (39%), similarly between groups (p=0.73). Conclusions. The age at diagnosis was high, the mul­ti­ple allergies were common, and the medical consults were excessive (allergen reintroduction attempts). A normal to­tal IgE does not exclude CMPA, and the absence of family al­ler­gies is frequent in cow’s milk protein allergy.