Evaluation of some predictive parameters for baked milk tolerance in
children with cow's milk allergy
Abstract
Background: The addition of baked-milk products to the diet appears to
markedly accelerate the development of tolerance to unheated-milk
compared to a strict avoidance diet. Objective: The present study aims
to investigate the predictors of baked milk tolerance in children with
IgE-mediated cow’s milk allergy. Methods: The study included 80 cases
who were diagnosed with IgE-mediated cow’s milk allergy upon oral food
challenge (OFC) testing in our clinic. Cases who did and did not develop
reactions during OFC with baked milk were compared regarding clinical
and laboratory parameters. Results: The cases with cow’s milk allergy
were 48 male and 32 female and the average age was 7.25 ± 2.45 (3-13)
months. We found that 62.5% of cases showed tolerance to baked milk in
the OFC test performed with cakes containing 2.6 g milk protein. When
the patients who could and could not tolerate baked milk products were
compared as for test results, we detected a statistically significant
difference intergroup regarding diameter of wheal in skin prick test
(SPT) performed with muffin slurry, levels of sIgE for cow’s milk (CM),
sheep’s milk (SM), goat’s milk (GM), casein, and the amount of unheated
milk consumed until a reaction developed in the OFC test performed with
unheated milk (p <0.05). Conclusion: We defined novel decision
points based on for CM, SM, GM, casein sIgE levels, wheal diameter in
SPT with muffin slurry, and the amount of milk ingested during OFC
performed with unheated milk that may be useful in predicting outcomes
to baked milk challenges.