Symptoms, diagnostics and therapy of allergy to cow’s milk

Abstract

Introduction. Diagnosis and treatment of allergy to cow’s milk is subject to dispute in the absence of specific symptoms and reliable diagnostic tests.Method. Databases were used to search for original articles and reviews on the subject.Results. As before, a «provocative test» is recommended as the most specific and sensitive diagnostic test, despite the fact that a positive provocative test does not prove involvement in the pathological process of the immune system. A provocative test is not only recommended in case of anaphylaxis, which is extremely rare.To raise awareness among physicians in order to better recognize symptoms caused by the consumption of cow’s milk, a Scale of symptoms arising from the use of cow’s milk (CoMiSS) has been developed but not yet validated. Today the recommended diagnostic approach includes an elimination diet with the intake of a complete hydrolysate of cow’s milk, followed by provocative tests. In severe cases amino acid mixtures are used. The growing popularity of rice hydrolysates is due to the fact that they have proven effective, better tolerated and cheaper than a mixture on the basis of a complete hydrolysate of cow’s milk. An additional alternative could be soy-based baby formulas as in accordance with the data of the review about 10–15% of children with allergy to cow’s milk will have the same response to soy.Use of probiotics could be an additional tool in the treatment of allergy to cow’s milk.Conclusion. For most patients, complete hydrolysates of cow’s milk remains the first tool in the treatment of allergy to cow’s milk and amino acid mixtures used in the most severe cases. Rice hydrolysates and soy infant formula are considered the second choice means.

Keywords

• allergy to cow’s milk
• diagnosis
• symptoms
• treatment
• elimination diet
• a mixture based on a complete hydrolysate of cow’s milk