Case report: An adult onset of cow's milk hypersensitive

Abstract

Rationale An adverse food reaction, either due to IgE mediated or non-IgE mediated immune mechanisms consists of any abnormal reaction after the ingestion of a food. Epidermiologic data indicate that about 6% children are affected by cow's milk and other foods. However, more than 80% these individuals will eventually loose their sensitivity to those foods. Thus it is generally recognized that cow's milk hypersensitivity as an early childhood disorder. Current literature is scarce on adult onset cow's milk related adverse reactions. Methods A 17 year-old female was treated at emergency department for recent onset of recurrent wheezes, cough, hoarseness and rhinorrea after cow's milk ingestion. No cutaneous or cardiovascular complications. She had no history of other associated atopy risk factors. Results The patient was positive with prick skin test (SPT) and class 3 IgE antibody toward cow's milk. Since elimination of cow's milk from her diet, patient had not experience any symptoms. Conclusions Due to the extreme reactivity to SPT and positive IgE antibody toward cow's milk, no double blind, placebo-controlled food challenge (DBPCFC) undertaken on the patient. DBPCFC is contraindicated for patient had severe anaphylactic reactions to the suspected food. Currently, either SPTs or radioallergosorbent studies might be used first for the diagnostic will rely on a positive test result in conjunction with a suggestive history. This experience suggests adult onset cow's milk hypersensitivity will be not easily recognized. Thus, more scientific knowledge on understanding of the disorder pathogenesis, diagnostic technique and therapy are needed.