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Improving the diagnosis of cow’s milk protein allergy in infants

Written by Shumatova Т.А., Shishatskaya S.N., Zernova E.S., Ni A.N., Katenkova E.Yu., Prikhodchenko N.G., Grigoryan L.A., Egorova S.V.

  UDK: 616-053.3-056.43-07: 613.287 | Pages: 19–22 | Full text PDF | Open PDF 

Annotation:

Objective. The research objective is to analyze the possibilities of using the rating clinical scale CoMiSS and the determination of endogenous proteins and peptides in coprofiltrates for the improvement of diagnosis of cow’s milk protein allergy (CMPA) in infants.
Methods. The study included 60 infants of the first year of life with suspected CMPA: 30 infants with CMPA (the 1st group), and 30 infants with the secondary lactase deficiency (the 2nd group). The control group included 20 healthy infants. We assessed clinical symptoms using CoMiSS instrument and cutaneous syndrome based on SCORAD index, determined in coprofiltrates endogenous proteins and peptides: β-defensin 2, zonulin, eosinophilic cationic protein.
Results. In the monitoring groups the total number of points on the scale CoMiSS the score was higher than in the control group, but not significantly different between groups. The differences in the severity of symptoms of lactase deficiency were also unreliable and symptoms of skin lesions were more common in the 1st group. The defeat of the respiratory tract is not registered in any of the child with a secondary hypolactasia. An increase in the β-defensin 2 in coprofiltrates was typical only for children with the CMPA, zonulin content in children of the 1st was 1.5 higher than that of children in the 2nd group, and 2.3 times higher than the control parameters. The level of eosinophil cationic protein in patients with the CMPA was 2.9 times higher than that of children in the 2nd group, and it was 2.7 times higher than in healthy children.
Conclusions. The widespread use of SCORAD index and the tool CoMiSS, and the analysis of the content of endogenous proteins and peptides in coprofiltrates can improve the diagnosis of the CPMA in infants by avoiding invasive research methods and provocative diets.

Links to authors:

Т.А. Shumatova1, S.N. Shishatskaya1, E.S. Zernova1, A.N. Ni1, E.Yu. Katenkova1, N.G. Prikhodchenko1, L.A. Grigoryan1, S.V. Egorova2
1 Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690950 Russian Federation),
2 Regional Clinical Center of Specialized Medical Care (30/37 Uborevicha St. Vladivostok 690091 Russian Federation)




1. Vishneva E.A., Namazova-Baranova L.S., Turti T.V. [et al.]. The allergy to cow›s milk protein. Approaches and algorithms of the treatment // Current pediatrics. 2012. Vol. 11, No. 3. P. 65–69.
2. Diagnosis and treatment of the allergy to cow›s milk protein from the infant and young child nutrition: practical advice / edited by A.A. Baranov, L.S. Namazova-Baranova, T.E. Borovik, S.G. Makarova. М.: Pediatr, 2014. 48 p.
3. Kazyukova T.V. The allergy to cow’s milk protein: the choice strategy of the clinical nutrition (literature review) // Effective Pharmacotherapy. Pediatrics. 2013. No. 3. P. 31–34.
4. Makarova S.G., Namazova-Baranova L.S., Borovik T.E. [et al.]. Gastrointestinal manifestations of the allergy to cow›s milk protein in children // Medical Council. 2014. No. 1. P. 28–34.
5. Petrovskaya M.I., Namazova-Baranova L.S., Vinyarskaya I.V. [et al.]. Linguistic ratification and evaluation of the psychometric properties of the Russian version of the specialized questionnaire flip to assess quality of life of the child›s family members with food allergies: first results // Pediatric pharmacology. 2015. Vol. 12, No. 6. P. 651–656.
6. СoMiSS – a tool a tool to raise awareness about the symptoms of allergy to cow›s milk protein and to assess their evolution // Current pediatrics. 2016. Vol. 15, No. 1. P. 112.
7. Shumatova T.A., Prikhodchenko N.G., Efremova I.V. [et al.]. Clinical and laboratory analysis of enteral nutritional support of children with severe disorders of intestinal absorption // Pacific Medical Journal. 2013. No. 1. P. 38–41.
8. Shumatova T.A., Shishatskaya S.N., Zernova E.S. [et al.]. Modern markers in the diagnosis of food intolerance in infants // Pacific Medical Journal. 2015. No. 3. P. 55–58.
9. Food Allergy and Anaphylaxis Guidelines. EAACI, 2014. 278 p.
10. Koletzko S., Niggemann B., Arato A. [et al.]. Diagnostic approach and management of cow›s milk protein allergy in infants and children: ESPGHIAN Gl committee practical guidelines // J. Pediatr. Gastroenterol. Nutr. 2012. Vol. 55. No. 2. Р. 221–229.
11. Vandenplas Y., Dupont C., Eigenmann P. [et al.]. A workshop report on the development of the Cow›s Milk-related Symptom Score awareness tool for young children // Acta Paediatr. 2015. Vol. 104, No. 4. Р. 334–339. doi: 10.1111/apa.12902.
12. Vandenplas Y., Marchand J., Meyns L. Symptoms, diagnosis, and treatment of cow›s milk allergy // Curr. Pediatr. Rev. 2015. Vol. 11, No. 4. Р. 293–297.

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