Cervantes BR, Zapata CCA, Hernández BV, Zárate MF, Sánchez PM, Montijo BE, Cadena LJF, Cazares MM, Ramírez MJA

Language: Spanish
References: 48
Page: 147-153
PDF size: 184.50 Kb.

ABSTRACT

Background: Allergy to proteins in cow’s mi k is a disorder with high prevalence worldwide, it is estimated that between 1 and 12% of the population suffers. The diagnosis is clinical and diagnostic tests are available with variable sensitivity and specificity.
Objective: To determine the utility of various diagnostic tests with clinical suspicion of allergy to proteins in cow’s milk in two groups of Mexican children.
Patients and methods: Observational, prospective and comparative study which included 73 children with suspected allergy to cow’s milk proteins treated at the Gastroenterology and Nutrition Service of the National Institute of Pediatrics, March 2008 to November 2009. They were divided into two groups with specific inclusion criteria: group 1, 37 infants with age limits of 1 and 6 months, not being weaned. Group 2, 36 infants with age limits of 7 and 13 months, weaned, of both sexes, with proof of negative hydrogen ions. We excluded patients with malnutrition, HIV seropositivity, history of metabolic diseases and neurological damage. Laboratory tests were performed: determination of total IgE, precipitins to cow’s milk, prick test, 24-hour intraesophageal pH monitoring, endoscopy and sigmoidoscopy. Administered a comprehensive formula of hydrolyzed whey protein or elemental diet.
Results: The clinical manifestations in groups 1 and 2 were, respectively: gastrointestinal, 97.2 vs 100%, kidney (renal tubular acidosis), 32 vs 33% skin, 29 vs. 41.6%, respiratory 27 vs 57.7%. Laboratory results in groups 1 and 2 were, respectively: positive IgE, 8.1 vs 8%, prick test, 37.8 vs 33%, histology, 40.5 vs 33%. The intraesophageal pH monitoring in groups 1 and 2 was positive in 8.1 vs16.6%, respectively. Extensive treatment with hydrolyzed whey protein in groups 1 and 2 was successful in 72.9 vs 91.6%, respectively.
Conclusions: The diagnosis of allergy to proteins in cow’s milk is clinical and is supported by the histological findings in the rectum. The frequency of renal tubular acidosis associated with allergy to proteins in cow’s milk is very high (32-33%), whereas gastroesophageal reflux disease associated with allergies is low (8-16%).

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