Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance

Introduction: Food allergies are responses triggered by various immunological mechanisms to foods or additives, manifesting through IgE, non-IgE or mixed-type reactions. In IgE-mediated food allergies, skin findings (such as urticaria, angioedema, skin redness) are common, along with cough, rhinorrh...

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Main Authors: Ughur Zeynallı, Muhammed Fatih Erbay, Şefika İlknur Kökçü Karadağ, Deniz Özçeker
Format: Article
Language:English
Published: Galenos Publishing House 2024-12-01
Series:Güncel Pediatri
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Online Access:https://www.guncelpediatri.com/articles/clinical-presentations-of-ige-mediated-cows-milk-allergy-in-children-and-factors-affecting-the-development-of-tolerance/doi/jcp.2024.07992
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author Ughur Zeynallı
Muhammed Fatih Erbay
Şefika İlknur Kökçü Karadağ
Deniz Özçeker
author_facet Ughur Zeynallı
Muhammed Fatih Erbay
Şefika İlknur Kökçü Karadağ
Deniz Özçeker
author_sort Ughur Zeynallı
collection DOAJ
description Introduction: Food allergies are responses triggered by various immunological mechanisms to foods or additives, manifesting through IgE, non-IgE or mixed-type reactions. In IgE-mediated food allergies, skin findings (such as urticaria, angioedema, skin redness) are common, along with cough, rhinorrhea, shortness of breath, and symptoms extending to anaphylaxis. This study aims to evaluate the clinical presentations and factors playing a role in tolerance development in patients diagnosed with IgE-mediated cow’s milk allergy (CMA). Materials and Methods: Our study encompasses a retrospective evaluation of the files of patients who were diagnosed with IgE-mediated CMA and developed tolerance, and who presented to the Prof. Dr. Cemil Taşçıoğlu City Hospital Pediatric Allergy and Immunology clinic between the years 2018-2022. Results: The average age of the 75 patients was 14.4 months, with 65.3% being males. Tolerance development was observed in 56% of patients before reaching 24 months of age. In the group with tolerance development age ≥ 24 months, statistically significantly higher rates of positive food challenge tests and inhalant allergen sensitivity were noted. In patients who developed tolerance after 24 months, family history of atopy, additional allergic diseases, and inhalant allergen sensitivity were more frequent. In this group, the mean skin prick induration diameter, serum-specific IgE levels for milk and casein, and total serum IgE levels were significantly higher. ROC analysis evaluated a cut-off point of 1.30 for casein-specific IgE with a sensitivity of 93% and a specificity of 67%. Conclusion: CMA is commonly observed in children, yet research on tolerance development is quite limited. However, our study, contrary to existing literature, suggests that tolerance can develop in a shorter period. Furthermore, we found that tolerance developed later in children with a family history of atopy, accompanying additional allergic diseases, and a history of anaphylaxis, as well as those with a larger skin prick induration diameter at the time of diagnosis, and higher levels of total serum IgE, milk-specific IgE, and casein-specific IgE.
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spelling doaj-art-db0ee017f9934d11b9ef2a0d27a899ff2025-08-20T01:59:05ZengGalenos Publishing HouseGüncel Pediatri1304-90541308-63082024-12-0122314014910.4274/jcp.2024.07992Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of ToleranceUghur Zeynallı0https://orcid.org/0009-0008-4926-6017Muhammed Fatih Erbay1https://orcid.org/0000-0002-4128-3081Şefika İlknur Kökçü Karadağ2https://orcid.org/0000-0001-9234-633XDeniz Özçeker3https://orcid.org/0000-0002-0032-6727University of Health Sciences Turkey Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Pediatric Allergy and Immunology, İstanbul, TurkeyUniversity of Health Sciences Turkey Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Pediatric Allergy and Immunology, İstanbul, TurkeyUniversity of Health Sciences Turkey Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Pediatric Allergy and Immunology, İstanbul, TurkeyUniversity of Health Sciences Turkey Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Pediatric Allergy and Immunology, İstanbul, TurkeyIntroduction: Food allergies are responses triggered by various immunological mechanisms to foods or additives, manifesting through IgE, non-IgE or mixed-type reactions. In IgE-mediated food allergies, skin findings (such as urticaria, angioedema, skin redness) are common, along with cough, rhinorrhea, shortness of breath, and symptoms extending to anaphylaxis. This study aims to evaluate the clinical presentations and factors playing a role in tolerance development in patients diagnosed with IgE-mediated cow’s milk allergy (CMA). Materials and Methods: Our study encompasses a retrospective evaluation of the files of patients who were diagnosed with IgE-mediated CMA and developed tolerance, and who presented to the Prof. Dr. Cemil Taşçıoğlu City Hospital Pediatric Allergy and Immunology clinic between the years 2018-2022. Results: The average age of the 75 patients was 14.4 months, with 65.3% being males. Tolerance development was observed in 56% of patients before reaching 24 months of age. In the group with tolerance development age ≥ 24 months, statistically significantly higher rates of positive food challenge tests and inhalant allergen sensitivity were noted. In patients who developed tolerance after 24 months, family history of atopy, additional allergic diseases, and inhalant allergen sensitivity were more frequent. In this group, the mean skin prick induration diameter, serum-specific IgE levels for milk and casein, and total serum IgE levels were significantly higher. ROC analysis evaluated a cut-off point of 1.30 for casein-specific IgE with a sensitivity of 93% and a specificity of 67%. Conclusion: CMA is commonly observed in children, yet research on tolerance development is quite limited. However, our study, contrary to existing literature, suggests that tolerance can develop in a shorter period. Furthermore, we found that tolerance developed later in children with a family history of atopy, accompanying additional allergic diseases, and a history of anaphylaxis, as well as those with a larger skin prick induration diameter at the time of diagnosis, and higher levels of total serum IgE, milk-specific IgE, and casein-specific IgE.https://www.guncelpediatri.com/articles/clinical-presentations-of-ige-mediated-cows-milk-allergy-in-children-and-factors-affecting-the-development-of-tolerance/doi/jcp.2024.07992food allergyige-mediated hypersensitivitymilk hypersensitivity
spellingShingle Ughur Zeynallı
Muhammed Fatih Erbay
Şefika İlknur Kökçü Karadağ
Deniz Özçeker
Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance
Güncel Pediatri
food allergy
ige-mediated hypersensitivity
milk hypersensitivity
title Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance
title_full Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance
title_fullStr Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance
title_full_unstemmed Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance
title_short Clinical Presentations of IgE-Mediated Cow’s Milk Allergy in Children and Factors Affecting the Development of Tolerance
title_sort clinical presentations of ige mediated cow s milk allergy in children and factors affecting the development of tolerance
topic food allergy
ige-mediated hypersensitivity
milk hypersensitivity
url https://www.guncelpediatri.com/articles/clinical-presentations-of-ige-mediated-cows-milk-allergy-in-children-and-factors-affecting-the-development-of-tolerance/doi/jcp.2024.07992
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