cow milk allergy

Cow Milk Allergy: Symptoms, Causes, and Diagnosis

A cow milk allergy (CMA) is an immune system response to the proteins found in cow's milk, primarily casein and whey. This reaction can cause a range of symptoms, from mild to severe.

Common Symptoms of Cow Milk Allergy:

• Stomach problems, such as vomiting, diarrhea, and abdominal pain [3]
• Itching, rash, and tingling around the mouth [4]
• Hives (urticaria) and itchy, red, weeping or crusty rash of the skin – dermatitis or eczema [2]
• Swelling of the face, lips, tongue, or throat
• Bloody stools, especially in infants [9]

Severe Symptoms:

• Anaphylaxis, a rare but potentially life-threatening reaction that requires immediate medical attention [6][9]

Causes and Diagnosis:

A milk allergy causes your immune system to overreact to milk proteins. Diagnosis can be difficult as it is primarily based on history and physical exam [1]. A child with an immediate reaction to cow's milk protein may develop symptoms like vomiting, diarrhea, mucous and/or blood in stools, and abdominal pain [8].

Important Note:

If you have a milk allergy, keep an epinephrine auto-injector handy in case of an emergency. Symptoms can range from mild to severe, so it's essential to be aware of the signs and seek medical attention if necessary.

References: [1] - Cow's milk allergy is an allergic reaction to the protein found in cow's milk. [2] - Symptoms of cow's milk allergy include raised red bumps of skin – hives (urticaria)... [3] - The signs might manifest as a skin rash or eczema, or involve the GI tract... [4] - A milk allergy causes your immune system to overreact to milk proteins. [5] - Symptoms include diarrhoea, vomiting, stomach (abdominal) pain and gas (wind or bloating). [6] - Symptoms of a milk allergy reaction can range from mild, such as hives, to severe... [7] - Cow's milk allergy (also known as cow's milk protein allergy or CMPA) is an immune system response... [8] - A child with an immediate reaction to cow's milk protein may develop symptoms like vomiting... [9] - Milk Allergy Symptoms · Hives · Stomach upset · Vomiting · Bloody stools, especially in infants...

Milk Allergy Signs and Symptoms

A milk allergy can cause a range of symptoms, from mild to severe, which can affect various parts of the body. Here are some common signs and symptoms of a cow's milk allergy:

• Digestive Problems: Diarrhea, vomiting, stomach cramps, gas, bloating, and abdominal pain are all possible symptoms of a milk allergy.
• Skin Issues: A skin rash or eczema can be a sign of an allergic reaction to milk proteins.
• Respiratory Symptoms: Wheezing, trouble breathing, coughing, hoarseness, throat tightness, and increased work of breathing can occur in some individuals.
• Other Symptoms: Some people may experience itching or a tingling feeling around the mouth or lips, hematochezia (blood in the stool), mucousy stool, and nausea.

These symptoms can vary from person to person and can range from mild to severe. If you suspect that you or your child has a milk allergy, it's essential to consult with a healthcare professional for proper diagnosis and treatment.

References:

• [1] Urticaria/hives, wheezing, itching or a tingling feeling around the mouth or lips, diarrhea, hematochezia, abdominal cramps.
• [2] Stomach problems, itching, rash, and tingling around your mouth.
• [3] Wheezing, trouble breathing, coughing, hoarseness, throat tightness, stomach upset, vomiting, diarrhea.
• [4] Skin rash or eczema, vomiting, abdominal pain, blood in the stool, mucousy stool, and diarrhea.
• [5] Diarrhea, vomiting, stomach (abdominal) pain and gas (wind or bloating).
• [6] Nausea, cramps, gas, bloating, and diarrhea.

Diagnosing Cow Milk Allergy: A Comprehensive Overview

Cow milk allergy (CMA) is a common condition in infants and young children, characterized by an immune system reaction to one or more proteins in cow's milk. Accurate diagnosis is crucial for developing an effective treatment plan and preventing potential complications.

Available Diagnostic Tests

Several tests can help diagnose CMA, including:

• Skin-prick test (SPT): This test measures the presence of IgE antibodies, which develop when the immune system reacts to milk proteins [7]. A SPT is a quick and relatively painless procedure that involves pricking the skin with a small amount of cow's milk extract.
• Blood test: A blood test can measure the levels of IgE antibodies specific to cow's milk proteins [6, 11]. This test is useful for confirming an allergy diagnosis when symptoms are severe or persistent.
• Stool test: A stool test checks for blood in the stool, which can be a symptom of CMA [5].
• Patch test: A patch test involves applying a small amount of cow's milk extract to the skin and observing any reaction over a period of time [8].

Other Diagnostic Approaches

In addition to these tests, healthcare professionals may also consider:

• Medical history and dietary review: A thorough medical history and dietary review can help identify symptoms and potential allergens [12].
• Elimination diet: An elimination diet involves removing cow's milk from the diet for a period of time to assess any improvement in symptoms [4].

Importance of Accurate Diagnosis

Accurate diagnosis is essential for developing an effective treatment plan and preventing potential complications, such as:

• Growth faltering
• Micronutrient deficiencies
• Acute reactions

By understanding the diagnostic tests available and their limitations, healthcare professionals can provide accurate diagnoses and develop personalized treatment plans for individuals with CMA.

References: [1] Vandenplas Y. (2007) [2] Majamaa H. (1999) [3] Martinson AK. (2024) [4] Context result 14 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 10 [11] Context result 11

Treatment Options for Cow Milk Allergy

Cow milk allergy (CMA) can be challenging to manage, but various treatment options are available to alleviate symptoms and prevent reactions. While there is no cure for CMA, the following drug treatments can help:

• Omalizumab: This biologic medication has been approved as a food allergy therapy and is available to treat milk allergy. It works by blocking the action of IgE antibodies, which are responsible for triggering allergic reactions [3].
• Cetirizine: In some cases, cetirizine may be prescribed in conjunction with omalizumab to help manage symptoms [2].

Important Considerations

It's essential to note that anaphylaxis, a severe and life-threatening allergic reaction, can occur at any time. If you or your child experiences symptoms such as difficulty breathing, rapid heartbeat, or swelling of the face, lips, tongue, or throat, seek immediate medical attention [5].

Treatment for Anaphylaxis

In the event of anaphylaxis, epinephrine (adrenaline) is the only treatment that can help alleviate symptoms. It's crucial to carry an auto-injector containing epinephrine at all times and to know how to use it properly [6].

Elimination Diet

For infants with cow milk protein-induced enterocolitis syndrome (CMPI), eliminating cow's milk protein from their diet is the primary treatment approach. This can be achieved by using extensively hydrolyzed formulas, which are made from cow's milk that has been broken down into smaller peptides [8].

Remember to consult an allergist for personalized advice on managing CMA and preventing reactions.

References:

[1] Not applicable (no relevant information in search results)

[2] Context 2: An off-label therapy with omalizumab (3 × 150 mg/month SC) and cetirizine 10 mg once daily was initiated.

[3] Context 3: Omalizumab (Xolair®) is the first biologic medication approved as a food allergy therapy. It is available to treat milk allergy.

[4] Not applicable (no relevant information in search results)

[5] Context 5: Anaphylaxis to cow's milk can be life threatening and should always be treated as a medical emergency.

[6] Context 6: An allergist will advise patients with a food allergy to carry an auto-injector containing epinephrine (adrenaline), which is the only treatment for anaphylaxis.

[7] Not applicable (no relevant information in search results)

[8] Context 8: Treatment of CMPI includes eliminating cow's milk protein from your infant's diet. This is usually started with an extensively hydrolyzed formula, which is made from cow's milk that has been broken down into smaller peptides.

The differential diagnosis for cow milk allergy (CMA) is extensive, given its wide range of symptoms that can be caused by the condition. Here are some possible conditions to consider:

• Food intolerance: This includes adverse reactions to other foods or non-food allergens.
• Anatomical abnormalities such as Meckel's diverticulum: This is a congenital anomaly that can cause gastrointestinal bleeding and other symptoms similar to CMA.
• Other food allergies: Such as soy, egg, wheat, and nut allergies, which can present with similar symptoms to CMA.
• Non-food allergies: Such as environmental or inhalant allergens, which can also cause allergic reactions.

According to [7], the differential diagnosis for CMA includes:

• Food intolerance (e.g. lactose intolerance)
• Allergic reaction to other food or non-food allergens
• Anatomical abnormalities such as Meckel's diverticulum

It is essential to note that a detailed clinical history and proper diagnostic testing are crucial in distinguishing CMA from these other conditions.

References:

[7] - Differential Diagnosis · Food intolerance (eg. · Allergic reaction to other food or non-food allergens · Anatomical abnormalities such as Meckel's diverticulum ...