BSACI guideline for the diagnosis and management of cow's milk allergy

Summary This guideline advises on the management of patients with cow's milk allergy. Cow's milk allergy presents in the first year of life with estimated population prevalence between 2% and 3%. The clinical manifestations of cow's milk allergy are very variable in type and severity...

Full description

Saved in:
Bibliographic Details
Published in:Clinical and experimental allergy 2014-05, Vol.44 (5), p.642-672
Main Authors: Luyt, D., Ball, H., Makwana, N., Green, M. R., Bravin, K., Nasser, S. M., Clark, A. T.
Format: Article
Language:English
Subjects:
aetiology
Allergies
allergy
anaphylaxis
Animals
BSACI
Cattle
desensitization
diagnosis
Disease Management
food
Food allergies
Humans
management
Milk
Milk Hypersensitivity - diagnosis
Milk Hypersensitivity - epidemiology
Milk Hypersensitivity - etiology
Milk Hypersensitivity - prevention & control
Milk Hypersensitivity - therapy
Prevalence
SOCC
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary This guideline advises on the management of patients with cow's milk allergy. Cow's milk allergy presents in the first year of life with estimated population prevalence between 2% and 3%. The clinical manifestations of cow's milk allergy are very variable in type and severity making it the most difficult food allergy to diagnose. A careful age‐ and disease‐specific history with relevant allergy tests including detection of milk‐specific IgE (by skin prick test or serum assay), diagnostic elimination diet, and oral challenge will aid in diagnosis in most cases. Treatment is advice on cow's milk avoidance and suitable substitute milks. Cow's milk allergy often resolves. Reintroduction can be achieved by the graded exposure, either at home or supervised in hospital depending on severity, using a milk ladder. Where cow's milk allergy persists, novel treatment options may include oral tolerance induction, although most authors do not currently recommend it for routine clinical practice. Cow's milk allergy must be distinguished from primary lactose intolerance. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for clinicians in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking the panel of experts in the committee reached consensus. Grades of recommendation are shown throughout. The document encompasses epidemiology, natural history, clinical presentations, diagnosis, and treatment.
ISSN:0954-7894
1365-2222
DOI:10.1111/cea.12302