Clinical manifestations of cows’ milk allergy in childhood. I. Associations with in‐vitro cellular immune responses

Abstract

In this study 51 children who presented with symptoms of cows' milk allergy (CMA) were categorized clinically by their response to cows' milk challenge. Forty-two patients had unequivocal evidence of CMA and nine were milk tolerant. Of the patients with CMA two groups were identified. The first, made up of 32 patients, had immediate-type hypersensitivity reactions to milk associated with both positive skin-prick test (SPT) and RAST. The second group of 10 late reacting patients developed symptoms of CMA over several hours or days; significant increases in irritability, frequency of bowel actions, and rhinitis following milk ingestion were noted in this group. Leucocyte inhibition factor (LIF) produced in response to alpha-lactalbumin, beta-lactoglobulin and alpha-casein was assessed in the immediate and late reacting CMA patients as well as in the milk-tolerant group. There was no difference in LIF production between the milk-tolerant group and those with immediate reactions. However, these two groups produced less LIF than the late reacting patients for alpha-lactalbumin (P = 0.02), alpha-casein (P = 0.03) and beta-lactoglobulin (P = 0.05). A clinical dairy score card was found to be a useful instrument to assess the response of non-immediate reactions to milk ingestion.