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Clinical characteristics, laboratory tests and tolerance acquisition in infants less than one year of age with cow's milk protein allergy in a private center in Lima -- Peru for the period 2021 -2022
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  • César Galván-Calle,
  • Cecilia Diaz Vasquez,
  • Wilmer Córdova-Calderón,
  • Juan Gomez de la Torre,
  • Edgar Matos-Benavides
César Galván-Calle
Emedic Salud

Corresponding Author:[email protected]

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Cecilia Diaz Vasquez
Instituto Nacional de Salud del Niño San Borja
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Wilmer Córdova-Calderón
Instituto Nacional de Salud del Niño
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Juan Gomez de la Torre
Laboratorios Roe SA
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Edgar Matos-Benavides
Instituto Nacional de Salud del Niño
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Abstract

Cow’s milk protein allergy (CMPA) in Latin America is little studied. We conducted a prospective study in 64 patients with a median age of 3 months, 39/64 (60.94%) were male, 23/64 (35.93%) had malnutrition, 56/64 (87.5%) had familiar atopy, 34/64 (51.56%) were receiving exclusive breastfeeding (EBF). The patients passed a medical evaluation by the specialist and underwent: Prick Test, ImmunoCAP, Fecal Calprotectin (FC) and fecal eosinophil derived neurotoxin (EDN), double-blind placebo control oral food challenges (DBPCFC) and were observed for one year regarding their clinical evolution and acquisition of tolerance. 58/64 (90.63%) had gastrointestinal manifestations, 7/64 (10.94%) had a dermatological manifestation, 2/64 (3.1%) had respiratory manifestations and 2/64 (3.1%) had anaphylaxis. 6/64 (9.38%) had an IgE - mediated CMPA. In patients with Non - IgE Mediated CMPA, fecal calprotectin was found to have a median of 284 mg/dL and an interquartile range (IQR) of 138.5 - 415.5. EDN had a median of 508.5 mg/dL with an IQR of 160.25 - 868. One year after diagnosis, the median FC decreased significantly with p < 0.0001. Malnutrition after one year was reduced to 17.18%. Likewise, 52/64 (81%) acquired tolerance after practicing DBPCFC on them. 33/64 (52%) used nutritional replacement formulas from the time of diagnosis, those who used Nutramigen LGG 15/16 (94%) acquired tolerance after practicing DBPCFC while 12/17 (71%) of those who used other formulas acquired tolerance (p. 0.08). Our findings are a good starting point for future studies that explore the diagnosis, acquisition of CMPA tolerance, and the use of hypoallergenic formulas with the particularities of our region.
28 Sep 2023Submitted to Immunity, Inflammation and Disease
10 Oct 2023Submission Checks Completed
10 Oct 2023Assigned to Editor
10 Oct 2023Review(s) Completed, Editorial Evaluation Pending
29 Jan 2024Editorial Decision: Revise Major
01 Feb 2024Assigned to Editor
01 Feb 2024Submission Checks Completed
01 Feb 2024Review(s) Completed, Editorial Evaluation Pending
01 Feb 2024Reviewer(s) Assigned
16 Feb 2024Editorial Decision: Revise Major
12 Mar 20242nd Revision Received
13 Mar 2024Submission Checks Completed
13 Mar 2024Assigned to Editor
13 Mar 2024Review(s) Completed, Editorial Evaluation Pending
31 Mar 2024Editorial Decision: Accept