L’immunothérapie orale au lait de vache : expérience d’un service de pédiatrie à Alger

Abstract

Oral immunotherapy (OIT) has been recognized as a promising treatment for persistent cow's milk allergy (CMA). The objective of this study is to analyze the clinical, biological and evolutionary characteristics of patients on OIT. MethodsProspective study carried out in the pediatric ward A at the Béni Messous University Hospital in Algiers, which concerned all the children followed for CMA and in whom an OIT was practiced. ResultsOne hundred and twenty-eight patients were followed for mediated CMA IgE of which 38 needed an OIT (22.8 %), 24 boys and 14 girls, median age 4.8 years (1.5–10.5), the initial dose was between 0.6 and 100ml, baked milk was used in all patients, 52.6 % of which was baked in a wheat matrix. The mean duration of ITO was 17.5 months with an average healing age of 6.5 years. A high level of IgE specific to cow's milk and particularly to casein was correlated with a more advanced healing age. 55.2 % had associated asthma. Single organ allergic reactions have been reported without adrenaline need except in one patient. ConclusionThe results are encouraging, 63 % consumption more than 200ml/day, the others are on a personalized therapeutic escalation. The kinetics of specific IgE and ST were used to guide the OIT. Although incidents were infrequent, vigilance was required during the ITO.