Remaining symptoms in half the children treated for milk allergy

The aim of this study was to investigate the cumulative incidence and predictive variables of treatment failure with a whey-based extensively hydrolyzed formula (w-eHF) in children with cow’s milk allergy (CMA). All children were diagnosed with CMA, using double-blind placebo-controlled food challen...

Full description

Saved in:
Bibliographic Details
Published in:European journal of pediatrics 2015-06, Vol.174 (6), p.759-765
Main Authors: Petrus, Nicole C. M., Schoemaker, Anne-Fleur A., van Hoek, Meike W., Jansen, Laura, Jansen-van der Weide, Marijke C., van Aalderen, Wim M. C., Sprikkelman, Aline B.
Format: Article
Language:English
Subjects:
Amino acids
Child
Child, Preschool
Children & youth
Cohort analysis
Double-Blind Method
Female
Food allergies
Humans
Hydrolysis
Logistic Models
Male
Medicine
Medicine & Public Health
Milk Hypersensitivity - physiopathology
Milk Hypersensitivity - therapy
Original Article
Parental rights
Pediatrics
Treatment Failure
Variables
Whey
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:The aim of this study was to investigate the cumulative incidence and predictive variables of treatment failure with a whey-based extensively hydrolyzed formula (w-eHF) in children with cow’s milk allergy (CMA). All children were diagnosed with CMA, using double-blind placebo-controlled food challenge (DBPCFC) with amino acid-based formula as placebo, and receive w-eHF treatment after diagnosis. Forty-nine children with CMA were included. w-eHF treatment failure was defined as incomplete resolution of original CMA symptoms upon w-eHF treatment and disappearance of these symptoms upon replacement of w-eHF with amino acid-based formula. A multiple logistic regression model was used to investigate which variables could predict treatment failure. Twenty-five (51 %; 95 % confidence interval (CI) 38–64 %) of the children with CMA failed on w-eHF. Only “gastrointestinal discomfort” was found to contribute independently to the probability of failing w-eHF, odds ratio (95 % CI) 8.994 (1.007–79.457). Conclusions : In half of the children with proven CMA, there is incomplete resolution of symptoms upon w-eHF treatment. This study needs to be repeated including DBPCFC with w-eHF to provide more definitive diagnosis, especially since gastrointestinal discomfort seems to be the sole predictive variable for treatment failure. In the meantime, a change in formula should be considered in children with incomplete symptom resolution upon w-eHF treatment.
ISSN:0340-6199
1432-1076
DOI:10.1007/s00431-014-2456-6