A Structured Gradual Exposure Protocol to Baked and Heated Milk in the Treatment of Milk Allergy - 21/11/18
, Yuri Zeldin, MD 2, 3, Leora Gotesdyner, MSc 1, Tali Stauber, MD 1, 4, 5, Ramit Maoz Segal, MD 5, Inga Binson, MD 3, Mira Dinkin, MD 3, Larisa Dinkowitz, MD 3, Danit Shahar, BSN 4, 5, Michal Deutch, BSN 5, Mazal Yaron, BSN 3, Ayelet Nevet, BSN 3, Avner Reshef, MD 5, Nancy Agmon-Levin, MD 1, 5, Ron S. Kenett, PhD 6, Mona I. Kidon, MD 1, 3, 4, 5Abstract |
Objective |
To evaluate the efficacy and safety of a structured gradual exposure protocol (SGEP) with extensively heated and baked milk in promoting allergy resolution in children with cow milk allergy (CMA).
Study design |
In a case control study, children with CMA aged 1-4 years who were treated with SGEP including extensively heated and baked milk, were compared with children treated with strict avoidance. Data were collected from medical records and from validated telephone questionnaires. Data analysis was performed using a nonparametric Kaplan-Meier and proportional hazard Cox regression model, after evaluation of the adequacy of the case control matching.
Results |
There were 43 children with milk allergy—26 (62%) males with a mean age at intervention of 21 months (range, 12-47 months)—who were treated with SGEP and followed to a mean age of 40 months (range, 20-82 months). The median age at resolution of CMA was compared with a matched group of 67 children treated with strict avoidance at least until 4 years of age or followed until earlier resolution, with a mean age at follow-up of 71 months (range, 11-176 months). The median estimated age at CMA resolution in the SGEP group was 36 months (95% CI, 34.5-49.7) compared with 98 months (95% CI, 82.4-114.1) in controls (P < .001). At last follow-up, 86% of treated children were tolerant to unheated milk proteins vs 52% of controls (P = .003).
Conclusion |
A structured protocol with extensively heated and baked milk seems to promote faster resolution of CMA.
Le texte complet de cet article est disponible en PDF.Abbreviations : CMA, EHBM, LEAP, OFC, SGEP, sIgE, SPT
Plan
| The authors declare no conflicts of interest. |
Vol 203
P. 204 - décembre 2018 Retour au numéro
Article précédent
- Predicting Maintenance of Any Breastfeeding from Exclusive Breastfeeding Duration: A Replication Study
- Ann M. Dozier, Elizabeth A. Brownell, Kelly Thevenet-Morrison, Hayley Martin, James I. Hagadorn, Cynthia Howard
- Echocardiographic Measurements of Right Ventricular Mechanics in Infants with Bronchopulmonary Dysplasia at 36 Weeks Postmenstrual Age
- Daniel E. Ehrmann, Peter M. Mourani, Steven H. Abman, Brenda B. Poindexter, Lindsey A. Morrow, Brandie D. Wagner, Michael V. Di Maria
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?