Milk allergy

Cow's milk allergy, KMA (English Cow's milk allergy, CMA) and cow's milk protein allergy, CMPA is a food allergy of type I ( immediate type ). This means that symptoms occur immediately or within two hours. In some cases, symptoms after the expiration of 48 hours were observed. Very rarely, to break the relevant complaints after a week. While the early symptoms caused by immunoglobulin E (IgE ) are arranged, with the late T- lymphocyte responses are responsible. The disease is often confused with lactose intolerance. Both diseases are similar in many symptoms, but have entirely different causes. A milk allergy occurs in 0.5 to 7 % of all children under two years ago. It usually manifests itself before or by 6 months of age, or after weaning of the infant. The cause is to be sought in the fact that cow's milk in Central Europe usually is the first foreign protein to which an infant is confronted. In about 17 to 85% of cases of allergic children can tolerate from milk after the first year of life. In adults, the incidence of cow's milk allergy from 0.7 to 1.2% is estimated. This was, especially in the Scandinavian countries, determined by means of RAST tests. In very rare cases, allergies occur on goat and sheep milk. However, these are mostly confined to southern countries. In most of these cases is based on an allergy to cow's milk.

Causes

25 different proteins in milk are included, which can act as an allergen. Especially various caseins, β - lactoglobulin ( β -LG ) and α -lactalbumin cause allergic reactions.

It all immunological mechanisms are summarized under a cow's milk allergy, which IgE-mediated reactions ( IgE-KMA/KMPA ) and other immunoglobulins ( non-IgE-KMA/KMPA ), in rare cases T lymphocytes expire.

Symptoms

The symptoms can be mild to pronounced. Affected are usually the skin, the digestive tract, respiratory tract, and in acute cases, the cardiovascular system.

The most commonly observed symptoms include:

On the skin:

  • Urticaria
  • Erythema
  • Itching
  • Eczema
  • Eczema deterioration

At the respiration:

  • Bronchial obstruction
  • Laryngeal edema
  • Allergic rhinitis
  • Bronchial asthma (some chronically )

In the digestive system:

  • Oral and Perioral swelling
  • Diarrhea with signs of malabsorption
  • Enteropathy
  • Bloody - mucoid stools as an indication of an allergic colitis
  • Food refusal
  • Failure to thrive
  • Severe colic
  • Constipation

In the cardiovascular system:

  • Anaphylactic shock

Diagnosis

For the diagnosis of cow's milk allergy various diagnostic procedures are available. These include:

  • Anamnesis ( Here, the keeping of a diary allergy problems are helpful)
  • Prick test
  • RAST test
  • Elimination diet
  • Exclusion diet
  • Basic diet
  • Determination of allergen-specific IgE antibodies in various sections of the gastrointestinal tract
  • Methyl histamine determination in 24- hour urine

Therapy

On the treatment of cow's milk allergy, various methods are available. The most widely used is the desensitization. Here, the patient is administered in milk steadily increasing doses. In severe cases of cow's milk allergy ( Starting 1:10 with a mixing ratio of 1:100 later) or a drop at a given this either in a solution. Is increased, the dosage administered of the milk, to the amount of 250 ml is reached. Even after the successful desensitization, patients should daily take some milk, otherwise the habituation effect may be lost again.

If the action just described does not work, only the strict avoidance of the causative substances is possible.

Radioallergosorbent test Medical history Digital Object Identifier
490737
de