Intérêt des prick-tests aux hydrolysats dans l’allergie IgE-dépendante aux protéines du lait de vache de l’enfant

Abstract

Allergy to cow's milk is the first allergy to appear in new born babies as soon as they are introduced to their first feeding bottles. There are two main immune forms of allergy to cow's milk: the immediate form known as “IgE-mediated”, when symptoms appear quickly after the allergen intake and the delayed form, or “not IgE-mediated”, when symptoms appear several hours after the allergen intake. A study was carried out at the Children's hospital in Toulouse to evaluate the use of hydrolysate prick tests when IgE-mediated milk allergy is present. The sample concerned 12 infants; 10 boys, on average aged four-months-old when symptoms first appeared, and aged nine months when seen for the first time at the hospital for an allergy check-up. For one child who showed no change on taking Nutramigen ®, it was decided to replace the hydrolysate formula with an amino-acid formula. The infants who showed positive results to the hydrolysate prick tests were prescribed another extensive protein hydrolysate formula. This study validates the guidelines which recommend that neither goat's milk nor sheep's milk should be used (positive results on eight of the 12 infants tested). It seems to be interesting to perform skin prick test with hydrolysate formulas in infants with IgE-mediated cow's milk allergy with aim of the hydrolysate choice.