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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.

Ivan Cherrez-Ojeda

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Background: Information/communication technologies such as mobile phone applications (apps) would enable chronic urticaria (CU) patients to self-evaluate their disease activity and control. Yet, recently Antó et al (2021) reported a global paucity of such apps for patients with CU. In this analysis, we assessed patient interest in using apps to monitor CU disease activity and control using questions from the CURICT study, Methods: The methodology for CURICT has been reported. Briefly, a 23-item questionnaire was completed by 1,841 CU patients from 17 UCAREs across 17 countries. Here, we analyzed patient responses to the CURICT questions on the use of apps for urticaria-related purposes. Results: As previously published, the majority of respondents had chronic spontaneous urticaria (CSU; 63%; 18% chronic inducible urticaria [CIndu]; 19% with both), were female (70%) and in urban areas (75%). Over half of patients were very/extremely interested in an app to monitor disease activity (51%) and control (53%), while only ~1/10 were not. Patients with both urticaria types vs those with CSU only (OR, 1.36 [1.03-1.79]) and females vs males (OR[95%CI], 1.47 [1.17-1.85]) were more likely to be very to extremely interested in an app to assess disease control. Conclusions: Overall, patients with CU were highly interested in using an app to assess their disease activity and control. Development of well-designed apps, specific to disease types (CSU, CIndU, CSU+CIndU, etc), validated by experts across platforms would help improve the management and possibly outcomes of CU treatment while providing important patient information to be used in future research.