Evaluation of cow milk protein sensitization in children suspected cow milk protein allergy

Abstract

Cow milk is one of the most common cause of food allergy in children age less than 5 years. Gastrointestinal and cutaneous manifestations are the most common presenting presentations. The diagnosis of cow milk allergy (CMPA) is mainly based on history, food elimination and re-challenge of cow milk. Evaluation of sensitization to cow milk is the additional investigation for the diagnosis. This study evaluates cow milk sensitization status by prick skin test and specific IgE to cow milk in children aged less than 5 years who are suspicious of non-severe CMPA and mainly presented with gastrointestinal and cutaneous manifestations in Thammasat University Hospital. Sixty-one patients were included in the study. The mean age of onset was 5 ± 10.9 months. Gastrointestinal presentations were presented in 36 patients (60.6%), followed by the skin presentations in 17 patients (27.9%). Positive skin prick test to cow milk was found 1 patient (4.4%); positive specific IgE to cow milk (> 5 kUA/L) was found in 2 patients (4.8%). Oral challenge to cow milk protein was positive in 14.8%. Oral food challenge is very helpful in confirming the diagnosis of CMPA, particularly in the non-IgE mediated group.