Natural course of cow's milk allergy in childhood atopic eczema/dermatitis syndrome. 2002

Arnold P Oranje, and Albert Wolkerstorfer, and Flora B de Waard-van der Spek
Department of Dermatology (Pediatric Dermatology, Sophia Children's Hospital), Erasmus MC, Rotterdam, The Netherlands. aoranje@inter.nl.net

OBJECTIVE This review was undertaken to determine the role of adverse reactions to bovine proteins in atopic dermatitis, recently called atopic eczema/dermatitis syndrome (AEDS). METHODS A PubMed literature search was conducted with use of the following phrases: atopic dermatitis and food allergy, atopic dermatitis and cow's milk, and cow's milk and eczema. METHODS The authors' judgment and personal interest guided the literature selection. RESULTS Food allergy has a role in at least 20% of the cases of AEDS in children younger than 4 years. Cow's milk is usually the first food given to an infant, and cow's milk hypersensitivity is often the first symptom of an atopic condition. Adverse reactions to cow's milk proteins are usually categorized as immunoglobulin (Ig)E-mediated or non-IgE-mediated cow's milk allergy and nonallergic hypersensitivity (intolerance); the symptoms do not allow differentiation of these entities. In patients with cow's milk allergy and AEDS, resolution occurs in 90% by the age of 4 years. Non-IgE-mediated cow's milk allergy often disappears before the age of 1 year. Associated reactions to other foods develop in approximately 45% of patients. Allergy to potential environmental inhalant allergens has been reported in up to 28% of patients by 3 years of age and up to 80% before puberty. After consumption of large amounts of cow's milk, 45% of 10-year-old children who had become tolerant of cow's milk, but also 15% of control subjects, still had gastrointestinal complaints. The presence of cow's milk allergy during infancy increases the risks for development of other food allergies, respiratory atopy, and persistence of AEDS. CONCLUSIONS Adverse reactions to bovine proteins have an important role in AEDS.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002417 Cattle Domesticated bovine animals of the genus Bos, usually kept on a farm or ranch and used for the production of meat or dairy products or for heavy labor. Beef Cow,Bos grunniens,Bos indicus,Bos indicus Cattle,Bos taurus,Cow,Cow, Domestic,Dairy Cow,Holstein Cow,Indicine Cattle,Taurine Cattle,Taurus Cattle,Yak,Zebu,Beef Cows,Bos indicus Cattles,Cattle, Bos indicus,Cattle, Indicine,Cattle, Taurine,Cattle, Taurus,Cattles, Bos indicus,Cattles, Indicine,Cattles, Taurine,Cattles, Taurus,Cow, Beef,Cow, Dairy,Cow, Holstein,Cows,Dairy Cows,Domestic Cow,Domestic Cows,Indicine Cattles,Taurine Cattles,Taurus Cattles,Yaks,Zebus
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003876 Dermatitis, Atopic A chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. It is manifested by lichenification, excoriation, and crusting, mainly on the flexural surfaces of the elbow and knee. In infants it is known as infantile eczema. Eczema, Atopic,Eczema, Infantile,Neurodermatitis, Atopic,Neurodermatitis, Disseminated,Atopic Dermatitis,Atopic Eczema,Atopic Neurodermatitis,Disseminated Neurodermatitis,Infantile Eczema
D005512 Food Hypersensitivity Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens in food. Allergy, Food,Food Allergy,Hypersensitivity, Food,Allergies, Food,Food Allergies,Food Hypersensitivities,Hypersensitivities, Food
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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