چکیده (انگلیسی):

Background: Low dose reactive cow's milk (CM) allergic children are at high risk of persistent CM allergy
and a positive oral food challenge (OFC). The present study aimed to evaluate if the results of a very low
dose (VL) OFC with these children contributes to better management of CM allergy.
Methods: We retrospectively reviewed subjects with CM allergy who underwent a VL OFC with 3 mL
heated CM and had a previous allergic reaction to <25 mL heated CM in the 2 years before the OFC.
Subjects who passed the OFC were defined as VL tolerant, and subjects who failed were defined as VL
reactive. VL tolerant subjects increased the dose to 25 mL heated CM either during an OFC in our hospital
or gradually at home.
Results: Of the 83 subjects (median age, 4.3 years; range, 1.0e12.9 years) who were included, 41 (49.4%)
were VL tolerant, and 42 (51.6%) were VL reactive. Thirty-nine VL reactive subjects had skin and/or
respiratory symptoms during the OFC. Most reactions could be treated with an antihistamine and/or a
nebulized b2 agonist. The VL tolerant subjects consumed 3 mL heated CM or 10 g butter. Within the year
following the OFC, 18 VL tolerant subjects (45.0%), but none of the VL reactive subjects, were able to
consume 25 mL heated CM (p < 0.001).
Conclusions: A VL OFC allows the management of some low dose reactive CM allergic children to change
from complete avoidance to partial intake of CM.