4CPS-005 Risk factors for persistence and tolerance of cow’s milk allergy

Background and importanceCow’s milk protein allergy (CMPA) is universally the most common food allergy in the first years of life, and the incidence has increased over the past few years. The presence of CMPA has important repercussions for patients and their families as it diminishes their quality...

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Published in:European journal of hospital pharmacy. Science and practice 2020-03, Vol.27 (Suppl 1), p.A49-A50
Main Authors: Giraldez Montero, JM, Duran Piñeiro, G, Varela Rey, I, Leis Trabazo, R, Zarra Ferro, I
Format: Article
Language:English
Subjects:
Age
Food allergies
Milk
Risk factors
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Summary:Background and importanceCow’s milk protein allergy (CMPA) is universally the most common food allergy in the first years of life, and the incidence has increased over the past few years. The presence of CMPA has important repercussions for patients and their families as it diminishes their quality of life.Aim and objectivesOur aims were to characterise our population of children with CMPA and to identify predictive factors for the persistence of this allergy.Material and methodsThis was a retrospective observational study in 168 children diagnosed with CMPA at the gastroenterology and nutrition unit undergoing treatment with special formulas for the management of CMPA, between 1 January and 31 March 2017, at the University Clinical Hospital of Santiago de Compostela. Clinical variables and complementary tests, perinatal and nutritional factors, symptoms and type of hydrolysed formula used was recorded. Children were followed-up to 2 years of age. A logistic regression analysis was used to investigate independent predictive factors for the persistence of CMPA beyond the age of 1 year of age.ResultsA total of 88 males (52.4%) with a mean age at diagnosis of CMPA of 3.27±2.82 months were studied: 31% did not have a differentiated diagnosis; 89.3% were born after 37 weeks’ gestation; 20.2% by caesarean section; 46.4% were breastfed; 36.1% were fed artificially; 17.5% had mixed feeding; and 47.1% had a first or second degree family history.Patients who began with gastrointestinal and/or cutaneous symptoms were observed to take longer to acquire tolerance than those with subjective symptoms at the beginning of the study (p=0.018). Patients with immunoglobulin E (IgE) mediated CMPA had more cutaneous symptoms (84%) than those not mediated by IgE. In 25 patients (14.9%), CMPA was IgE mediated, of whom only 24% resolved their intolerance before 1 year of age. Mean age of resolution was 18.77±6.25 months.The most commonly used substitution formulas in our study were hydrolysed lactose free milk protein formulas.Conclusion and relevanceThe findings of the study showed that the presence of IgE mediated CMPA, gastrointestinal and/or cutaneous symptoms had negative effects on tolerance. No perinatal or nutritional risk factors were found to predict the persistence of CMPA.References and/or acknowledgements1. Carrard A, Rizzuti D, Sokollik C. Update on food allergy. Allergy 2015;70:1511–1520.No conflict of interest.
ISSN:2047-9956
2047-9964
DOI:10.1136/ejhpharm-2020-eahpconf.106