Therapeutic value of hypoallergic formulas in infants with hypersensitivity dermatosis to cow's milk protein

Abstract

Twenty children of both sexes, from one to two years of age with dermatosis appearing after introduction of cow’s milk or derivatives in their diet, were studied from a clinical and a laboratory point of view. To investigate the existence of an allergy to the proteins of cow’s milk and to evaluate the therapeutic effect of an hypoallergic formula made of casein hydrolysate. In fourteen children (70 %) there was a family history of atopic disease and in seventeen (85 %) the total IgE (PRIST) was higher than 2SD above the average for that age, proving the presence of an atopic background. In eight children (40 %) RAST was positive (class 3 and 4) for cow’s milk, which is in favour of type I allergy. Other immunological mechanisms may have been present in the remaining cases in which RAST was negative. In fourteen children (70%) there was a good clinical response to diet exclusion and the hypoallergic formula was well tolerated. An oral challenge test was carried out in eight children after a period of exclusion diet not shorter than three months. A clinical relapse was observed in two of them and in the others cow’s milk was progressively reintroduced in the diet. The authors conclude that cow’s milk is an important cause of childhood dermatosis, especially in children who have a high allergic risk and the use of hypoallergic formulas is a treatment to be considered in these situations.