Natural progress of cow's milk allergy

Natural Progress of cow?s milk AllergyBackground and aim: Cow?s milk allergy is the most common food allergy effecting %2-3 of pediatric population. Due to tolerance growth in first 3 years, prognosis is good. Our purpose in our study was to research natural progress and determines factors affective on tolerance in patients with the prognosis of cow?s milk allergy.Patients and Methods: This study is a retrospective study of patients who was diagnosed cow milk allergy with OFC (Oral Food Challenge). In this study 102 patient files analyzed and patients with certain diagnosis by using OFC and 3 years of follow up were included. Patients? gender, symptom onset age, diagnosis age, family history of atopi, duration of breastfeeding, age at onset of complementary foods were questioned. Ig E, milk spesific Ig E and skin prick test results were analyzed. Clinic symptoms of cow milk alergy at first contact and affecting factors were evaluated. Tolerance and risk factors for the persistence of CMA at the and of the 3rd fear were also analyzed.Results: There were 36 male (61%) and 23 female (39%). %61 (36) of patients had family history of atopy. Mean diagnosis age was 10 (2-108) months. Mean breast feeding duration was 8 months and mean age at onset of complementary foods was 4 mounts. Most common clinical diagnosis was atopic dermatitis/ urticaria (%68). Patients showed %20 gastrointestinal symptoms, %14(n=8) had asthma, and %10 (n=6) had the diagnosis of rhinitis. Milk specific Ig E levels at the diagnosis was 3,26 kUA/L (0-101), total Ig E level was 133 IU/ml (6,78-987). %46 (27) of patients had skin prick test at over 3x3 cm wheal diameter. Most accompaning allergen to cow milk allergy was egg allergy in and seen 29 (%49) patients. 6 patients (%10) had beef allergy. After 3 years it was detected that %15 (9) patients had grown inhalant allergy. %50 of patients with asthma had mite, %37 of patients had mold allergy. %31 (18) of patients recovered at the end of first year, %68 (40) after 2 years and %83 (49) recovered after 3 years. Positive family history (p=0,048), presence of beef allergy (p=0,011), high levels of milk specific Ig E (p=0,006), skin prick test positivity (p=0,025), presence of asthma clinic were the factors that effected persistent cow milk allergy.Conclusion: In our study family atopy history increased persistency of CMA 3,601 times at the end of first year. Also it was detected that asthma effected prognosis. Prognosis were poor in the patients with higher milk specific Ig E levels. Positive skin prick test presences of beef allergy were the other factors effective on persistency.Keywords: Cow?s milk Allergy, cow?s milk allergy prognosis, cow?s milk allergy natural history.