Benefits of baked milk oral immunotherapy in French children with cow's milk allergy
Benefits of baked milk oral immunotherapy in French children with cow's milk allergy
Authors:
Vianney Gruzelle, Agnès Juchet, Audrey Martin-Blonde, Marine Michelet, Anne Chabbert-Broue, Alain Didier
Abstract:
Background: Introduction and gradual incremental escalation of a low dose of baked
milk may accelerate the resolution of severe cow's milk (CM) allergy for some children. The purpose of our study was to evaluate the efficacy and safety of baked milk
oral immunotherapy (OIT) in children with CM allergy after a low-dose baked milk
oral food challenge (OFC).
Methods: In a retrospective analysis of OFC performed between 2013 and 2018 at
the Children's Hospital of Toulouse (France), we identified 64 children with CM allergy and high milk and casein-specific IgE levels, who underwent a total of 171 milk
OFC. Mean age at 1st OFC was 4.8 years. Mean CM-specific IgE was 47.9 kUA/L, and
mean casein-specific IgE was 42.3 kUA/L.
Results: Most children were treated with baked milk OIT. Our study shows that 67.2%
of the children did not react to 1st low-dose baked milk OFC (168.6 mg of CM protein). Eighteen percent of children stopped the OIT at home. Finally, desensitization
to fresh milk was achieved in 27 children (42.2% of children allergic to CM). Children
with lower CM-specific IgE levels have a significantly higher probability of becoming
desensitized to unbaked CM.
Conclusion: Most children with CM allergy and high milk and casein-specific IgE levels tolerate the introduction of baked milk. However, the occurrence of anaphylactic
reactions during OIT remains possible.
DOI: 10.1111/pai.13216
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