Long-Term Follow Up In Cow's Milk Anaphylaxis After Successful Rush Oral Immunotherapy

Abstract

RationaleOral food desensitization is a promising therapeutic aproach in patients with persistent cow’s milk allergy (CMA). Although it seems that these protocols show a better outcome in those afflicted with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitised subjects.MethodsPatients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. Starting from a 1/100 milk dilution, the patients were progressively exposed to incresing doses ut to 4 ml of undiluted milk. The second phase of the current study was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period.ResultsTen children (2-15 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Significant clinical and serological changes were obtained not only in the first six months but during the subsequent five years.ConclusionsHighly sensitised CMA patients may benefit from rush oral Cow’s Milk immunotherapy. Clinical and serological changes have been found both at early and long-term stages of the follow-up. RationaleOral food desensitization is a promising therapeutic aproach in patients with persistent cow’s milk allergy (CMA). Although it seems that these protocols show a better outcome in those afflicted with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitised subjects. Oral food desensitization is a promising therapeutic aproach in patients with persistent cow’s milk allergy (CMA). Although it seems that these protocols show a better outcome in those afflicted with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitised subjects. MethodsPatients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. Starting from a 1/100 milk dilution, the patients were progressively exposed to incresing doses ut to 4 ml of undiluted milk. The second phase of the current study was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period. Patients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. Starting from a 1/100 milk dilution, the patients were progressively exposed to incresing doses ut to 4 ml of undiluted milk. The second phase of the current study was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period. ResultsTen children (2-15 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Significant clinical and serological changes were obtained not only in the first six months but during the subsequent five years. Ten children (2-15 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Significant clinical and serological changes were obtained not only in the first six months but during the subsequent five years. ConclusionsHighly sensitised CMA patients may benefit from rush oral Cow’s Milk immunotherapy. Clinical and serological changes have been found both at early and long-term stages of the follow-up. Highly sensitised CMA patients may benefit from rush oral Cow’s Milk immunotherapy. Clinical and serological changes have been found both at early and long-term stages of the follow-up.