Cow milk protein reintroduction in children presenting IgE-mediated cow milk allergy: modalities and failure predictive factors

Abstract

Background: The outcome of cow's milk allergy (CMA) usually progresses to acquisition of tolerance by three years of age. Methods: Retrospective study of 61 children followed in the paediatric department of Mongi Slim hospital for IgE-mediated CMA who had a reintroduction of cow's milk during 2005-2016. Results: The OCT was performed in hospital in 26 cases (43%), failed in 46%. Cow's milk was reintroduced at home in 35 cases (57%), failed in 20%. Increased SPT weal size during follow-up and a last cow's milk IgE level over 2 KU/l were identified as major risk factors independently associated to failure of reintroduction. Conclusion: Increased SPT weal size during follow-up and elevated level of cow's milk sIgE may predict the failure of reintroduction.