Prediction of the development of tolerance to milk in children with cow's milk hypersensitivity.

Full Abstract

OBJECTIVES: To investigate whether the development of tolerance to cow's milk (CM) by aged 4 years can be predicted with a skin prick test (SPT) and measurements of total or specific immunoglobulin E (IgE) in the serum, taken at the time of diagnosis of cow's milk hypersensitivity (CMH). STUDY DESIGN: Infants with immediate (n=95) or delayed (n=67) challenge reactions to CM were prospectively followed to aged 4 years. CMH status was assessed annually by CM challenges. RESULTS: By aged 2, 3, and 4 years, children with delayed reactions developed tolerance to CM faster than those with immediate reactions: 64%, 92%, and 96% versus 31%, 53%, and 63%, respectively. A wheal size of <5 mm in SPT correctly identified 83% of 124 infants who developed tolerance to CM by aged 4 years, and a wheal size of >or=5 mm in SPT correctly identified 71% of 39 infants with persistent CMH. Milk-specific IgE <2 kU/L correctly identified 82% of infants who developed tolerance to CM, and milk-specific IgE >or=2 kU/L correctly identified 71% of infants with persistent CMH. CONCLUSION: SPT and milk-specific IgE in the serum are useful prognostic indicators of the development of tolerance to CM in infants with CMH.

Author information

Author/s: Vanto, Timo (T); Helppilä, Sinikka (S); Juntunen-Backman, Kaisu (K); Kalimo, Kirsti (K); Klemola, Timo (T); Korpela, Riitta (R); Koskinen, Pertti (P);

Affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland. timo.vanto(-atsign-)tyks.fi

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: The Journal of pediatrics (J Pediatr), published in United States. (Language: eng)

Reference: 2004-Feb; vol 144 (issue 2) : pp 218-22

Dates: Created 2004/02/04; Completed 2004/03/16; Revised 2006/11/15;

PMID: 14760265, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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