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Cow's Milk Desensitization in Anaphylactic Patients: A New Personalized-Dose Method Pubmed



Babaie D1 ; Nabavi M2 ; Arshi S2 ; Mesdaghi M3 ; Chavoshzadeh Z1 ; Bemanian MH2 ; Tafakori M1 ; Amirmoini M1 ; Esmailzadeh H4 ; Molatefi R2, 5 ; Rekabi M6 ; Akbarpour N2 ; Masoumi F7 ; Fallahpour M2
Authors
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Authors Affiliations
  1. 1. Department of Allergy and Clinical Immunology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, P.O. Box: 13131-14456, Tehran, Iran
  3. 3. Department of Immunology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Allergy Research Center, Shiraz University of Medical Science, Shiraz, Iran
  5. 5. Department of Pediatrics, Bo-ali Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
  6. 6. Pediatric Respiratory Diseases Research Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Allergy# Asthma and Immunology Published:2017


Abstract

Cow's milk allergy (CMA) is the most frequent food allergy in children and oral immunotherapy (OIT) is a promising approach for treatment of patients. The most challenging cases are anaphylactic with coexisting asthma and proposing safe protocols is crucial especially in high risk groups. Considering that CMA varies among patients, an individualized OIT protocol would be beneficial to achieve a safer and more efficient method of desensitization. 18 children more than 3 years of age with IgE-mediated CMA were enrolled. CMA was confirmed by positive skin prick test (SPT) and positive oral food challenge (OFC) and 60% of individuals had a convincing history of persistent asthma. SPT with milk extracts, whole fresh milk and serially diluted milk concentrations were performed. The dilution of milk that induced 3-5 mm of wheal in each individual was selected as the starting dilution for OIT. Desensitization began by 1 drop of the defined dilution and continued increasingly. Overall, 16 out of 18 children (88.8%) achieved the daily intake of 120 mL of milk. Four out of these 16 children accomplished the protocol without any adverse allergic reactions. 12 patients experienced mild to severe reactions. Wheal and erythema in SPT (p≤0.001), and sIgE (p≤0.003) to most milk allergens were significantly decreased following desensitization. We successfully desensitized 16 of 18 children with IgE-mediated CMA by individualized desensitization protocol. Individualizing the OIT protocol would be helpful to save time and perhaps to relieve the allergic symptoms after ingesting cow's milk intake. © Winter 2017, Iran J Allergy Asthma Immunol. All rights reserved.
Related Docs
1. The Efficacy of Oral Immunotherapy in Patients With Cow's Milk Allergy, Iranian Journal of Allergy# Asthma and Immunology (2017)
2. Induction of Tolerance by Oral Immunotherapy in Patients With Cow’S Milk Allergy, Journal of Investigational Allergology and Clinical Immunology (2016)
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