Kirsi M Järvinen1, Pantipa Chatchatee. 1. Division of Pediatric Allergy and Immunology and Jaffe Institute for Food Allergy, The Mount Sinai School of Medicine, New York, New York 10029-6574, USA. kirsi.jarvinen@mssm.edu
Abstract
PURPOSE OF REVIEW: Cow's milk allergy affects 2-3% of young children, the economic impact of which necessitates search for simple diagnostic tools and affordable milk substitutes. This review examines recent studies on the diagnosis of cow's milk allergy as well as on the allergenicity of milk from other mammalian species. RECENT FINDINGS: Resolution of symptoms during strict milk avoidance and their re-appearance during the double-blind, placebo-controlled milk challenge remains the gold standard for the diagnosis of cow's milk allergy. Allergic eosinophilic esophagitis/gastroenteritis requires confirmatory endoscopic biopsy. There are increasing data in various populations on cut-off points based on positive predictive values for skin prick test and milk-specific IgE measurements to aid in the diagnosis of cow's milk allergy and to decrease the number of unnecessary food challenges. For non-IgE-mediated manifestations, noninvasive diagnostic tests are still largely lacking. The significant homology between milk from cow, sheep and goat results in clinical cross-reactivity. However, mare's or donkey's milk may be tolerated by some individuals. SUMMARY: Data have been accumulating on the utility of diagnostic tools for mostly IgE-mediated milk allergy and allergenicity of milk from other mammalian species, although further studies are sought.
PURPOSE OF REVIEW: Cow's milk allergy affects 2-3% of young children, the economic impact of which necessitates search for simple diagnostic tools and affordable milk substitutes. This review examines recent studies on the diagnosis of cow's milk allergy as well as on the allergenicity of milk from other mammalian species. RECENT FINDINGS: Resolution of symptoms during strict milk avoidance and their re-appearance during the double-blind, placebo-controlled milk challenge remains the gold standard for the diagnosis of cow's milk allergy. Allergic eosinophilic esophagitis/gastroenteritis requires confirmatory endoscopic biopsy. There are increasing data in various populations on cut-off points based on positive predictive values for skin prick test and milk-specific IgE measurements to aid in the diagnosis of cow's milk allergy and to decrease the number of unnecessary food challenges. For non-IgE-mediated manifestations, noninvasive diagnostic tests are still largely lacking. The significant homology between milk from cow, sheep and goat results in clinical cross-reactivity. However, mare's or donkey's milk may be tolerated by some individuals. SUMMARY: Data have been accumulating on the utility of diagnostic tools for mostly IgE-mediated milk allergy and allergenicity of milk from other mammalian species, although further studies are sought.
Authors: Joshua A Boyce; Amal Assa'ad; A Wesley Burks; Stacie M Jones; Hugh A Sampson; Robert A Wood; Marshall Plaut; Susan F Cooper; Matthew J Fenton; S Hasan Arshad; Sami L Bahna; Lisa A Beck; Carol Byrd-Bredbenner; Carlos A Camargo; Lawrence Eichenfield; Glenn T Furuta; Jon M Hanifin; Carol Jones; Monica Kraft; Bruce D Levy; Phil Lieberman; Stefano Luccioli; Kathleen M McCall; Lynda C Schneider; Ronald A Simon; F Estelle R Simons; Stephen J Teach; Barbara P Yawn; Julie M Schwaninger Journal: J Allergy Clin Immunol Date: 2010-12 Impact factor: 10.793
Authors: Joana Costa; Caterina Villa; Kitty Verhoeckx; Tanja Cirkovic-Velickovic; Denise Schrama; Paola Roncada; Pedro M Rodrigues; Cristian Piras; Laura Martín-Pedraza; Linda Monaci; Elena Molina; Gabriel Mazzucchelli; Isabel Mafra; Roberta Lupi; Daniel Lozano-Ojalvo; Colette Larré; Julia Klueber; Eva Gelencser; Cristina Bueno-Diaz; Araceli Diaz-Perales; Sara Benedé; Simona Lucia Bavaro; Annette Kuehn; Karin Hoffmann-Sommergruber; Thomas Holzhauser Journal: Clin Rev Allergy Immunol Date: 2021-01-07 Impact factor: 8.667