J Korean Med Sci.  2011 Sep;26(9):1152-1158. 10.3346/jkms.2011.26.9.1152.

Natural Course of Cow's Milk Allergy in Children with Atopic Dermatitis

• Suh J
• Lee H
• Lee JH
• Cho J
• Yu JS
• Kim J
• Han Y
• Ahn K
• Lee SI

• KMID: 1779387
• DOI: http://doi.org/10.3346/jkms.2011.26.9.1152

Abstract

Cow's milk is one of the most common food allergens in children with atopic dermatitis (AD). This study was conducted to describe the natural course of cow's milk allergy in children with AD, and to identify factors predictive of outcome. To accomplish this, we reviewed the medical records of 115 children who were diagnosed with AD and cow's milk allergy before 24 months of age to evaluate their clinical characteristics and prognostic factors. During a follow-up period of 24 to114 months, the median age for tolerance to cow's milk was found to be 67 months. Multivariate analysis using the Cox proportional hazard model revealed that the peak cow's milk-specific IgE level within 24 months after birth was the most important factor for prediction of the outcome of cow's milk allergy. In conclusion, half of the children younger than 24 months of age with AD and cow's milk allergy could tolerate cow's milk at 67 months of age. The peak cow's milk-specific IgE level within the first 24 months of birth is useful to predict the prognosis of cow's milk allergy in children with AD.

Keyword

Milk; Food Hypersensitivity; Immunoglobulin E; Prognosis

MeSH Terms

Animals
Cattle
Child
Child, Preschool
Dermatitis, Atopic/complications/*diagnosis
Female
Follow-Up Studies
Humans
Immune Tolerance
Immunoglobulin E/blood
Infant
Male
Milk/immunology
Milk Hypersensitivity/complications/*diagnosis
Odds Ratio
Prognosis
Time Factors

Figure

• 

  Fig. 1 Development of tolerance to cow's milk. Kaplan-Meier survival curve shows cow's milk allergy resolution over time in children with atopic dermatitis.

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  Fig. 2 Development of tolerance to cow's milk according to peak cow's milk-specific IgE level during the first 24 months after birth. (—) Solid line shows tolerance to cow's milk by patients with peak cow's milk-specific IgE levels during the first 24 months after birth of less than 15 kU/L. (---) Dotted line shows tolerance to cow's milk by patients with peak cow's milk-specific IgE levels during the first 24 months after birth of 15 kU/L or more.

• 

  Fig. 3 Trend in cow's milk-specific IgE levels over time based on final cow's milk allergy status. Each dot represents all cow's milk-specific IgE levels recorded by age. (A) All values in the group with tolerance of cow's milk allergy. (B) All values in the group with persistence of cow's milk allergy.

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