Validation of Cow Milk-Related Symptom Score as an Awareness Tool in the Diagnosis of Cow’s Milk Protein Allergy among Infants

Abstract

ow’s milk protein allergy (CMPA) is defined as an immune-mediated response to proteins in cow’s milk that occurs consistently with ingestion of milk. It is one of the most common and early causes of infant food allergy, affecting 1.4-3.8% of young children. The most commonly affected organs are the skin (50–70%), the gastrointestinal system (50–60%) and the respiratory system (20–30%). Generally, immune-mediated reactions to cow’s milk are categorized as immunoglobulin E (IgE)-mediated, non-IgE mediated, and mixed (IgE combined with non-IgE). Approximately 60% of those with CMA have the IgE-mediated form. A definitive diagnosis of IgE-mediated CMPA is confirmed by the history of an instant reaction with classic allergic symptoms and positive serum IgE(sIgE) or Skin Prick tests (SPT). In the diagnosis of non-IgE-mediated CMPA, specific IgE tests are not useful, so history taking is very important to aid with the diagnosis of a food allergy. A double-blind, placebo-controlled oral food challenge (DBPCFC) is the gold standard and the most specific test for diagnosis of CMPA.