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著者: Arnon Elizur, Nelly Rajuan, Michael R Goldberg, Moshe Leshno, Adi Cohen, Yitzhak Katz
雑誌名: J Pediatr. 2012 Sep;161(3):482-487.e1. doi: 10.1016/j.jpeds.2012.02.028. Epub 2012 Apr 4.
Abstract/Text
OBJECTIVE: To describe the natural course of IgE-mediated cow's milk allergy (IgE-CMA) and to determine risk factors for its persistence in a population-based cohort.
STUDY DESIGN: In a prospective cohort study, 54 infants with IgE-CMA were identified from a population of 13 019 children followed from birth. Diagnosis of IgE-CMA was based on history, skin prick test (SPT), and an oral food challenge (OFC) when indicated. Allergic infants were followed for 48-60 months. Families were contacted by telephone every 6 months and asked about recent exposures to milk. OFC was repeated to evaluate for recovery. Clinical characteristics, SPT, and OFC outcomes were compared between infants with persistent IgE-CMA and infants who recovered.
RESULTS: Thirty-one infants (57.4%) recovered from IgE-CMA during the study period. Most infants (70.9%) recovered within the first 2 years. Risk factors for persistence on multivariate analysis included a reaction to <10 mL of milk on OFC (or on first exposure as estimated by the guardian, if OFC was not performed) (P = .01), a larger wheal size on SPT (P = .014), and age of ≤30 days at time of first reaction (P = .05).
CONCLUSIONS: Resolution occurs in most infants with IgE-CMA. Infants reacting to <10 mL of milk or in the first month of life, and those with a larger wheal size on SPT, are at increased risk for persistence.
Copyright © 2012 Mosby, Inc. All rights reserved.
PMID 22480700 J Pediatr. 2012 Sep;161(3):482-487.e1. doi: 10.1016/j.jpeds.2012.02.028. Epub 2012 Apr 4.
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