Evaluation of epidemiological, laboratory and clinical features of patients with cow's milk protein allergy

Introduction and Purpose: Although food allergies are known to increase day by day, the exact prevalence in our country has not been determined. Although food allergies are known to be more common in childhood than adults, we also know that tolerance may develop at a later age. In addition, the importance of cow's milk protein allergy has been understood in recent years and physicians' awareness of this issue has increased. We know that cow's milk protein allergy can present in many ways in a patient. In our study, it was aimed to evaluate and compare the epidemiological, laboratory and clinical conditions of our patients who were followed up with Cow's Milk Protein Allergy Materials and Methods: In our study; It is aimed to compare the clinical features, presence of factors affecting prenatal and postnatal factors and laboratory results of our patients diagnosed with cow's milk protein allergy, who applied to our outpatient clinics. Patients diagnosed with cow's milk protein allergy in our outpatient clinics between January 2014 and July 2019 were retrospectively reviewed. Gender of patients, age at which first symptoms occurred, age at diagnosis, amount of time patients were breastfed, multiple food allergy, family history of allergy, gestation age, whether the patient received antibiotherapy in hospital during the neonatal period, whether the mother smoked during pregnancy, whether the mother used antibiotics during pregnancy and the systems and clinical findings of the patients' allergic findings were evaluated and noted. Findings: Of the 104 patients included in our study, 52 (50%) were found to be male 52 (50%) as female. The age at which the symptoms first started was found to be 2 months on average. At the time of diagnosis, the average age was calculated as 8.25 months. While the duration of breastfeeding was 6 months on average, an allergy history was found in 23.1% of the families of the patients (n = 24). Respiratory findings were observed in 12 (11.53%) patients, dermatitis in 79 (75.96%), and GIS findings in 69 (66.34%). Multiple food allergies were detected in 19 (18.26%) of the patients. Potato allergy was found in 1 (5%), dried nuts in 2 (10.52%), and egg allergy in 16 (84.2%) of patients with multiple food allergies. In 44 (42.3%) of our patients with a diagnosis of Cow's Milk Protein Allergy (CMPA), blood eosinophil levels were found to be higher than normal, above 4% or 400 / μL. In 14 (73.7%) of our 19 patients with multiple food allergies, the blood eosinophil level was found to be high. When patients were evaluated statistically, patients with multiple food allergies had higher eosinophil levels with statistical significance (P = 0.02). Discussion and Results: Cow milk protein allergy is the most common food allergy in the infant period. In this disease which affects many systems of the body, it is known that symptoms and growth-development retardation could be reversed by early diagnosis. It should be kept in mind that Cow's Milk Protein Allergies that present with gastrointestinal involvement can also be seen without evidence of blood test or skin prick test, so the diagnosis should be made with a well-established anamnesis, thorough examination and the food elimination diet. A significant elevation in blood eosinophil level was found in patients with CMPA who also had multiple food allergy. Therefore, especially in patients with eosinophilia and CMPA, it is thought that we can use food elimination diet by removing other foods, primarily eggs, according to the allergy frequency these foods have. Keywords: Cow's milk protein allergy, allergic reaction, food allergy, eosinophilia, multiple food allergy