milk allergy

A milk allergy, also known as cow's milk allergy, is an abnormal response of the body's immune system to the proteins in milk. This reaction can cause various symptoms, including:

• Hives (urticaria)
• Itchy, red, weeping or crusty rash of the skin – dermatitis or eczema
• Swelling of lips, face, or eyes
• Tingling mouth
• Abdominal (stomach) cramps
• Diarrhea
• Vomiting

In severe cases, a milk allergy can cause anaphylaxis, a life-threatening reaction that narrows the airways and can block breathing. Milk is the third most common food to cause anaphylaxis, after peanuts and tree nuts.

A milk allergy occurs when the immune system mistakenly triggers a defensive response to proteins in milk, which are normally harmless. This response can be unpredictable, ranging from mild to severe, and symptoms may take hours to days to manifest.

It's worth noting that most people with a milk allergy will not be able to eat cheese made with cow’s milk or other milk from mammals (goat, sheep, etc.), but they may be able to eat some non-dairy or vegan cheeses. People who have a milk intolerance or are lactose intolerant may find they can eat cheese made with milk and not develop symptoms.

References:

• [1] Approximately 70% of children with cow milk allergy tolerate baked cow milk.
• [2] Baked milk can be defined as milk that has been extensively heated ...
• [3] itchy, watery, or swollen eyes; hives; swelling; a drop in blood pressure, causing lightheadedness or passing out. Allergic reactions to milk can vary.
• [4] Symptoms of cow's milk allergy · raised red bumps of skin – hives (urticaria) · itchy, red, weeping or crusty rash of the skin – dermatitis or eczema · swelling of ...
• [5] Signs of mild to moderate allergic reactions include swelling of lips, face or eyes, hives (urticaria) or welts on the skin, tingling mouth, abdominal (stomach) ...

Common Signs and Symptoms of Milk Allergy

A milk allergy can cause various symptoms, ranging from mild to severe. Here are some common signs and symptoms:

• Skin Issues: Hives (urticaria), itchy, red, weeping or crusty rash of the skin (dermatitis or eczema) [3][5]
• Respiratory Problems: Wheezing, trouble breathing, coughing, hoarseness, throat tightness [6]
• Gastrointestinal Issues: Stomach upset, vomiting, diarrhea, nausea, stomach cramps, bloating, gas [7][8]

In severe cases, a milk allergy can cause anaphylaxis, a life-threatening condition that requires immediate medical attention.

Lesser-Known Symptoms

Some people with a milk allergy may experience non-IgE-mediated symptoms, which can include:

• Chronic Skin Issues: Some individuals may develop chronic skin issues, such as eczema or dermatitis [13]

It's essential to note that these symptoms can vary in severity and may not be immediately apparent. If you suspect a milk allergy, consult with a healthcare professional for proper diagnosis and treatment.

References:

[3] Context 3: "Atopic dermatitis, or eczema, can be one of the first signs that a milk allergy is present." [5] Context 5: "Signs and symptoms of milk allergies. If your child is allergic to milk protein, it may cause..." [6] Context 6: "What Are the Signs & Symptoms of a Milk Allergy? · wheezing · trouble breathing · coughing · hoarseness · throat tightness" [7] Context 7: "Symptoms · Diarrhea · Nausea, and sometimes, vomiting · Stomach cramps · Bloating · Gas..." [8] Context 8: "Unlike milk allergy, intolerance doesn't involve the immune system. Milk intolerance requires different treatment from true milk allergy." [13] Context 13: "Here are some lesser-known symptoms of a non-IgE-mediated milk allergy: 1. Chronic skin issues..."

Diagnostic Tests for Milk Allergy

Milk allergy can be diagnosed through various tests, which help healthcare professionals determine if a person has an immune reaction to milk proteins. Here are some common diagnostic tests used to diagnose milk allergy:

• Blood Test: A blood test measures the levels of allergen-specific antibodies called Immunoglobulin E (IgE) in the blood. This test is usually positive for people with an IgE-mediated milk allergy [6][7].
• Skin Prick Test: A skin prick test involves placing a small amount of milk extract on the skin and pricking it with a tiny needle to allow the allergen to enter the body. If the person has an allergic reaction, a raised bump or redness will appear at the site [4][5].
• Elimination Diet: An elimination diet involves removing milk and milk products from the diet for a period of time to see if symptoms improve. This test is often used in conjunction with other tests to confirm a diagnosis [5][6].
• Hydrogen Breath Test: A hydrogen breath test measures the amount of hydrogen gas produced by bacteria in the gut after consuming lactose (a sugar found in milk). This test can help diagnose lactose intolerance, which may be related to milk allergy [8].

Other Tests

In some cases, healthcare professionals may use other tests to confirm a diagnosis of milk allergy. These include:

• Physical Test: A physical examination and medical history are used to assess symptoms and determine if they are related to milk consumption.
• Allergy History: An allergist will ask about the person's history of allergies, including any previous reactions to milk or other foods.

Important Notes

It's essential to note that no single test can definitively diagnose a milk allergy. A healthcare professional may use a combination of tests and medical history to confirm a diagnosis [14]. Additionally, some people with milk allergy may not have an IgE-mediated reaction, making it more challenging to diagnose [4].

References:

[2] Vandenplas Y, Koletzko S, Isolauri E, et al. Guidelines for the diagnosis and management of cow's milk protein allergy in infants.

[3] The diagnostic value of skin prick testing in children with food allergy. Pediatr Allergy Immunol 2004; 15:435.

[4] Bumps, hives, and digestive problems are signs and symptoms of milk allergy.

[5] Signs and symptoms of milk allergy range from mild to severe and can include wheezing, vomiting, hives, and digestive problems.

[6] Milk allergy can also cause anaphylaxis — a severe, life-threatening reaction.

[7] Avoiding milk and milk products is the primary treatment for milk allergy. Fortunately, most children outgrow milk allergy.

[8] The prevalence of cow’s milk allergy (CMA) is estimated to be 0.5–0.74% in the first year of life [2, 3].

Treatment Options for Milk Allergy

If you have a milk allergy, there are several treatment options available to manage your symptoms and prevent severe reactions.

• Antihistamines: Antihistamines such as cetirizine and omalizumab can be prescribed by a healthcare provider to alleviate mild allergy symptoms [2]. However, they may not provide complete relief from all symptoms.
• Epinephrine Auto-Injectors (EpiPens): A healthcare provider should prescribe an epinephrine auto-injector for individuals with milk allergies. Epinephrine quickly reverses the symptoms of a severe allergic reaction [3].
• Oral Immunotherapy: Oral immunotherapy is an effective treatment for milk allergies, providing protection against accidental exposures [6]. This treatment involves gradually introducing small amounts of milk into your system to build up tolerance.
• Medications for Anaphylaxis: In case of a severe allergic reaction, medications such as epinephrine are crucial in treating anaphylaxis. Patients with milk allergies should carry an epinephrine auto-injector at all times [8].

Important Considerations

When considering treatment options, it's essential to consult with a healthcare provider who can assess your individual needs and recommend the best course of action.

• Medication Management: Your doctor may prescribe medication to assist with your milk allergy. Antihistamines can offer some relief from minor allergic reactions [7].
• Accidental Exposure: If you accidentally consume milk, it's crucial to have an emergency plan in place, including carrying an epinephrine auto-injector and knowing how to administer it.

Recent Developments

In recent years, new treatments have been developed to manage food allergies. For example, Xolair is the first FDA-approved medication to reduce allergic reactions to more than one type of food after accidental exposure [5].

References:

[2] B Klein · 2023 · Cited by 2 [3] [5] Feb 16, 2024 [6] [7] [8]

Differential Diagnosis of Milk Allergy

Milk allergy, also known as cow's milk protein allergy (CMPA), can be challenging to diagnose due to its similarity with other conditions. The differential diagnosis of milk allergy involves ruling out other possible causes of symptoms and signs that may mimic those of a milk allergy.

Possible Differential Diagnoses:

• Food intolerance: Lactose intolerance, for example, can cause similar symptoms such as bloating, gas, and diarrhea.
• Allergic reaction to other food or non-food allergens: Other foods, environmental factors, or substances can trigger allergic reactions that may be mistaken for a milk allergy.
• Anatomical abnormalities: Conditions like Meckel's diverticulum can cause symptoms similar to those of a milk allergy.

Other Differential Diagnoses:

• Acute Gastritis
• Acute Urticaria
• Bacterial Gastroenteritis
• Bulimia Nervosa
• Celiac Disease (Sprue)
• Chronic Gastritis