Clinical Characteristics, Laboratory Findings, and Tolerance Acquisition in Infants With Cow's Milk Protein Allergy in a Private Center in Lima, Peru for the Period 2021-2022
Author Type(s)
Resident/Fellow
Document Type
Article
Publication Date
4-1-2024
DOI
10.1002/iid3.1246
Journal Title
Immunity, Inflammation and Disease
Department
Pediatrics
Abstract
BACKGROUND: Cow's milk protein allergy (CMPA) remains relatively understudied in Latin America.
METHODS: In this observational study, we enrolled 64 patients with a median age of 3 months, of whom 60% were male. Patients included had a history of IgE-mediated reactions with IgE sensitization or non-IgE-mediated reactions or symptoms following exposure to cow's milk. They underwent skin prick test, ImmunoCAP, fecal calprotectin (FC), and fecal eosinophil-derived neurotoxin (EDN), in addition to double-blinded placebo-controlled oral food challenges (DBPCFC), with clinical evolution and tolerance acquisition observed over 1 year.
RESULTS: Malnutrition was present in 78.1% of patients, and 87.5% had a family history of atopy, with 51.6% receiving exclusive breastfeeding. Gastrointestinal manifestations were prevalent in 90.6% of patients, followed by dermatological manifestations (10.9%), with only 2 experiencing anaphylaxis. IgE-mediated CMPA was observed in only six patients. In those with non-IgE-mediated CMPA, FC had a median of 284 mg/dL (IQR: 138.5-415.5), while EDN had a median of 508.5 mg/dL (IQR: 160.25-868). One year after diagnosis, median FC significantly decreased (p < 0.0001), and malnutrition prevalence reduced to 17.1%. Moreover, 81% of patients acquired tolerance following DBPCFC, with 52% utilizing nutritional replacement formulas at diagnosis. Notably, 94% of those extensively hydrolyzed casein-based formulas achieved tolerance (p = 0.08).
CONCLUSION: Our findings provide a foundational framework for future investigations into CMPA diagnosis, tolerance acquisition, and the utilization of hypoallergenic formulas tailored to the unique characteristics of our region.
Recommended Citation
Calle, C., Díaz-Vásquez, C., Córdova-Calderón, W., Gómez de la Torre, J., Matos-Benavides, E., & Toribio-Dionicio, C. (2024). Clinical Characteristics, Laboratory Findings, and Tolerance Acquisition in Infants With Cow's Milk Protein Allergy in a Private Center in Lima, Peru for the Period 2021-2022. Immunity, Inflammation and Disease, 12 (4), 1246-1246. https://doi.org/10.1002/iid3.1246
