Posted by: Indonesian Children | May 9, 2010

The Natural History of IgE-Mediated Cow’s Milk Allergy

PEDIATRICS Vol. 122 Supplement November 2008, pp. S186 (doi:10.1542/peds.2008-2139X)

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sicherer, S. H.
Right arrow Search for Related Content
Right arrow Articles by Sicherer, S. H.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What’s this?


The Natural History of IgE-Mediated Cow‘s Milk Allergy

Scott H. Sicherer, MD, FAAP

New York, NY


Skripak JM, Matsui EC, Mudd K, Wood RA. J Allergy Clin Immunol. 2007;120(5):1172–1177

PURPOSE OF THE STUDY. Cow‘s milk allergy (CMA) is generally reported to resolve in 85% of children by the age of 3 to 5 years. This study evaluated the rate of resolution of CMA in a food-allergy referral population with emphasis on factors predicting resolution.

STUDY POPULATION. Final selection of charts for review and abstraction were obtained from clinical records of 4117 patients seen by 1 of the authors over 14 years; 1368 patients had food allergy, and 1073 patients had CMA. After excluding non–immunoglobulin E (IgE)-mediated disease and fewer than 2 visits, 807 patients’ charts were reviewed.

METHODS. A retrospective chart review was conducted, and 3 definitions were applied regarding tolerance of cow‘s milk. The strictest definition (1) was tolerating home introduction or a supervised food challenge, the second definition (2) included those with a milk-specific IgE level of❤ kU/L and no history of clinical reactions in 1 year, and the least stringent criteria (3) included a milk-specific IgE level of <15 kU/L and no history of clinical reactions in the preceding year.

RESULTS. When tolerance was defined by using the most stringent criteria, only 5% outgrew their allergy by 4 years of age, 21% by 8 years of age, 37% by 12 years of age, and 55% by 16 years of age. With criteria 2, the rates of resolution were 19% at 4 years of age, 42% by 8 years of age, 64% by 12 years of age, and 79% by 16 years of age. For the least stringent criteria (3), 26% were tolerant by 4 years of age, 56% by 8 years of age, 77% by 12 years of age, and 88% by 16 years of age. The higher the milk-specific IgE level noted per patient, the less likely was prompt resolution (P < .001). Coexisting asthma (P < .001) and allergic rhinitis (P < .001) were also significant predictors of delayed tolerance.

CONCLUSIONS. The prognosis for CMA in this population was worse than previously reported. However, some patients developed tolerance during adolescence, indicating that follow-up and reevaluation of patients with CMA is important in their care. Cow‘s milk–specific IgE levels are highly predictive of outcome.

REVIEWER COMMENTS. It is depressing to see recent studies supporting a slower resolution of common food allergies (see also the following review on a study about egg allergy). However, the good news is that hope is not lost when an allergy persists into school age; these studies confirm that children may continue to “outgrow” allergies into adolescence and that repeated evaluations are helpful. It must be appreciated that this study represents a referral population that likely is enriched for children with a more persistent phenotype of milk allergy.

Provided by

children’s ALLERGY CENTER online


PHONE : (021) 70081995 – 5703646

email :\ 





Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider. 



Copyright © 2010, Children Allergy Center Information Education Network. All rights reserved

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: