الفهرس 
COW’S MILK ALLERGYOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Cow milk protein allergy (CMPA) is a major health concern; its prevalence is between 1.9% and 4.9% in the first year of life. Tolerance to cow’s milk is tested after at least 6 months of elimination diet through two common approaches which are the milk ladder method and direct milk administration.
Aim: Primary objective: To compare tolerance frequency between those who had milk products reintroduced via milk ladder to those who were directly exposed to pure milk antigen after 6 months of elimination diet. Secondary objective: is to assess the factors affecting the overall tolerance frequency of cow’s milk after 6 months elimination diet.
Methods: A randomized controlled clinical trial involving 116 children recruited from the pediatric gastroenterology clinic of Ain Shams University, diagnosed as non-IgE mediated cow’s milk protein allergy proven by elimination re-challenge test and followed six months of elimination diet. The included children were randomly assigned into 2 groups, where one group had milk products reintroduced via milk ladder, and the second group had direct milk administration. They were followed up for 2 months after the introduction of milk or milk containing products to confirm resolution of allergy.
Results: The overall tolerance rate after 6 month elimination diet was 81% with no significant difference between the two approaches (Direct milk 84.5%, Milk ladder 77.6%), in addition, the regression analysis showed that weight was a significant factor influencing the resolution of CMPA patients, with normal weight patients having higher chance of resolution than underweight patients (odds ratio=3.73).
Conclusion: Non-IgE medicated CMPA has high rate of resolution after 6 month elimination diet. Both approaches of introduction are equivalent.