Prevalence of allergic diseases is increasing worldwide, including food allergy. It is different between countries because food allergy can vary by culture and population. Prevalence of food allergy in Indonesia is unknown; therefore it is not known yet the burden and impact of food allergy in our population. However, we already start to formulate guidelines for diagnosis and management of food allergy, especially cow's milk allergy.
Diagnosis ; Food Hypersensitivity ; Indonesia ; Milk Hypersensitivity ; Prevalence

Nowadays the use of cow's milk as a substitute for human breast milk is gradually increasing and many adverse reactions have been reported. Cow's milk is one of the important allergens, causing skin symptoms in infancy. We experienced a case of atopic dermatitis in a 9-month-old male infant having allergy to cow's milk. He showed itch, erythema and edema on the perioral area within a few minutes after oral feeding of cow's milk. During oral provocation, the infant showed clinical symptoms in concordance with intake of cow's milk. Diagnosis of cow"s milk allergy was confirmed by skin prick test and open oral food challenge test with cow's milk. The patient has been treated successfully with the elimination of cow's milk. We report the case with a brief review of related literatures.
Allergens ; Dermatitis, Atopic* ; Diagnosis ; Edema ; Erythema ; Humans ; Hypersensitivity ; Infant ; Male ; Milk Hypersensitivity* ; Milk* ; Milk, Human ; Skin

The diagnosis and treatment of cow's milk protein allergy (CMPA) is still a challenge. A systematic literature search was performed using Embase, Medline, The Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Clinical Trials for the diagnosis and treatment of cow's milk allergy (CMA). Since none of the symptoms of CMPA is specific and since there is no sensitive diagnostic test (except a challenge test), the diagnosis of CMPA remains difficult. A "symptom-based score" is useful in children with symptoms involving different organ systems. The recommended dietary treatment is an extensive cow milk based hydrolysate. Amino acid based formula is recommended in the most severe cases. However, soy infant formula and hydrolysates from other protein sources (rice) are gaining popularity, as they taste better and are cheaper than the extensive cow's milk based hydrolysates. Recent meta-analyses confirmed the safety of soy and estimate that not more than 10-15% of CMPA-infants become allergic to soy. An accurate diagnosis of CMA is still difficult. The revival of soy and the development of rice hydrolysates challenge the extensive cow's milk based extensive hydrolysates as first option and amino acid formula.
Child ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Hypersensitivity* ; Infant ; Infant Formula ; Milk Hypersensitivity ; Milk Proteins* ; Milk*

Table 2 contains a typographical error.
Consensus* ; Diagnosis* ; Hypersensitivity* ; Middle East* ; Milk Proteins*

PURPOSE: Cow's milk-specific IgE (CM-IgE) has been proposed as one of the valuable markers for diagnosis of clinical cow's milk (CM) allergy. In this study, we evaluated the additional usefulness of casein-specific IgE (casein-IgE) and IgG (casein-IgG) for the diagnosis of clinical CM allergy. METHODS: Fifty-eight subjects, aged from 3 months to 154 months, were enrolled. Thirty-four patients showed immediate-type of clinical CM allergy, and 24 patients were atopic controls. The serum levels of CM-IgE, casein-IgE, and casein-IgG were measured. Patients were divided into 2 groups: those aged under 12 months and those aged 12 months or over. The diagnostic values of each antibody were analyzed and compared using the Mann-Whitney U-test and receiver operating characteristic curves. RESULTS: CM allergy had significantly higher levels of CM-IgE and casein-IgE, and lower levels of casein-IgG/IgE ratio when compared to atopic controls in both age groups (P<0.05). CM-IgE and casein-IgE were shown to be better predictive markers for immediate-type CM allergy in patients under 12 months, while casein-IgG/IgE ratio was a more useful marker in those aged 12 months or over. Considering 100% positive predictive values, cutoff points were 1.04 kU/L for CM-IgE, 0.11 kU/L for casein-IgE, 19.5 for casein-IgG/IgE ratio in patients aged under 12 months, and 7.1 kU/L for CM-IgE, 1.41 kU/L for casein-IgE, 12.51 for casein-IgG/IgE ratio in those aged 12 months or over. CONCLUSION: CM-IgE, casein-IgE, and casein-IgG/IgE ratio are useful markers for predicting immediate-type CM allergy. Further studies are needed on diagnostic decision points for CM allergy using combination of cutoff values of these 3 markers.
Anaphylaxis ; Antibodies* ; Caseins* ; Diagnosis ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulin G* ; Milk ; Milk Hypersensitivity* ; ROC Curve

Cow milk allergy can be defined as an adverse immunologic reactions to cow milk protein. The term is often mistakenly applied to other causes of milk intolerence, such as lactase deficiency and galactosemia, which must be differenciated and excluded. We have experienced 10 children of cow milk allergy at neonatal onset who had suffered from G-I symtoms, such as diarrhea, irritability, weight loss, vomiting and abdominal distension. One half of this patients had family history of allergic diseas. All patients have positive specific IgE RAST to cow's milk protein, milk elimination test and milk challenge test. Brest milk feeding and soy bean formula feeding and soy bean formula feeding have started after diagnosis and then gastrointestinal symtoms and signs of all patients are improved but other allergic diseases are combined in 5 children.
Child ; Diagnosis ; Diarrhea ; Galactosemias ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Infant* ; Lactase ; Milk ; Milk Hypersensitivity ; Milk Proteins ; Soybeans ; Vomiting ; Weight Loss

PURPOSE: A Cow's milk allergy (CMA) is one of common problems during first year of life. Though milk caused allergic problems, their parents didn't know it, and gave milk to their children. But the parents don't give milk to their children if they know it. Therefore it may cause problems of growth and development in children. The purpose of this study is to analyze those clinical features of milk allergy confirmed by oral provocation test. METHODS: We carried out the retrospective study on 21 patients who had been performed oral milk provocation test at Yonsei university children's allergic clinic. RESULTS: 9 out of 21cases (43%) showed positive milk oral provocation test. The most common clinical symptom & sign was urticaria, followed by respiratory symptoms and abdominal symptoms. The rate which past history and positive skin test corresponded to oral provocation test was very high (100%). CONCLUSION: The most valuable diagnosis of food allergy is oral provocation test. However, predictive value of allergy skin test and past history was very high in milk allergy.
Child ; Diagnosis ; Food Hypersensitivity ; Growth and Development ; Humans ; Hypersensitivity ; Milk Hypersensitivity ; Milk* ; Parents ; Retrospective Studies ; Skin Tests ; Urticaria

Hematemesis is a rare condition in infants and can be a symptom of cow's milk-induced hemorrhagic gastritis. Other clinical manifestations of cow's milk allergy are vomiting, malnutrition and anemia. The criteria for the diagnosis of cow's milk allergy includes elimination of cow milk formula resulting in improvement of symptoms, specific endoscopic and histologic findings as well as exclusion of other causes. Cow's milk allergy should be considered in the etiologic differential diagnosis of hematemesis and gastritis in infancy. We have experienced a 1-month-old female infant with hematemesis due to cow's milk-induced hemorrhagic gastritis, and report the case with a review of previously published cases.
Anemia ; Diagnosis ; Diagnosis, Differential ; Female ; Gastritis* ; Hematemesis ; Humans ; Infant ; Infant, Newborn ; Malnutrition ; Milk Hypersensitivity* ; Milk* ; Vomiting

Gastroesophageal reflux (GER) and cow's milk allergy (CMA) are common disorders in infants. In recent years, more and more research has investigated the relationship between these two diseases. Some studies reported that about half of the cases of GER in infants younger than 1 year may be an association with CMA. Therefore, overall understanding the role of CMA on the pathogenesis of GER has a great importance on improving clinical level of diagnosis and therapy. This review article tried to elaborate advances in research on the relationship between CMA and GER in infants, including epidemiology, pathogenesis, clinical manifestations, diagnosis and treatment.
Gastroesophageal Reflux ; diagnosis ; etiology ; Humans ; Infant ; Milk Hypersensitivity ; complications

Food allergy is defined as abnormal immune response elicited by food intake, in which a variety of clinical symptoms will appear as a result of physiological dysfunction and/or tissue damage. Possible mechanisms for food allergy include gastrointestinal tract barrier damage, failure to induce oral immune tolerance, intrauterine sensitization, and allergen transmission during pregnancy and breastfeeding. Hereditary and environmental factors can also contribute to the disease. Gastrointestinal disorders are the main clinical manifestations of the disease. However, hypoalbuminemia, growth retardation, and even acute circulatory failure or shock may occur in severe cases. Oral food challenges are the "gold standard" for the diagnosis of food allergy. Avoidance and replacement of the responsible food are the only effective treatment options for neonatal food allergy. The use of probiotics can offer protection against the disease.
Food Hypersensitivity ; classification ; diagnosis ; etiology ; therapy ; Humans ; Infant, Newborn ; Milk Hypersensitivity ; diagnosis ; etiology ; therapy