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Slovenska pediatrija 2016; 23: 24-30

https://doi.org/



Research article

COW’S MILK ALLERGY IN THE NEONATAL PERIOD: REVIEW OF CLINICAL PRESENTATION AND LABORATORY TESTS

M. Jakič
Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

M. Jager
Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

G. Nosan
Klinični oddelek za neonatologijo, Pediatrična Klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Abstract

Background. Cow’s milk allergy (CMA) is an adverse immune response to one or more of the proteins in cow’s milk. The clinical presentation of CMA in the neonatal period is very diverse and nonspecific. The only method that can definitively confirm or refute CMA is the challenge test, which is rarely carried out due to possible complications. The diagnosis of CMA is instead based on the determination of serum immunoglobulin E (IgE) levels or clinical improvement after implementation of an allergen elimination diet. Materials and methods. In the analysis, 361 subjects with suspected CMA were included. Details of the clinical signs and the tests used to confirm the diagnosis of CMA were obtained from the available medical records. The acquired data was statistically analysed using Fisher’s exact test and Spearman’s analysis. Results. The clinical signs of CMA in the neonatal period showed high sensitivity (95 %) and low specificity (10 %). We proved a positive correlation between eczema and CMA (p <0.001) and between haematochezia and CMA (p <0.001). Conclusions. The most sensitive sign of CMA in the neonatal period is eczema, and the most specific sign is abdominal colic. The most commonly used confirmatory test for CMA in the neonatal period is the evaluation of total and specific serum IgE.

Key words: cow’s milk hypersensitivity, newborn, exanthema, gastrointestinal haemorrhage


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