Chronic diarrhea due to cow's milk allergy. A 4- to 10-year follow-up study.
There is general agreement that chronic diarrhea due to cow's milk allergy (CMA) resolves with a cow's milk-free diet, and that tolerance to cow's milk is achieved by 2 years of life. We have followed for 4 to 10 years, 41 infants with chronic diarrhea due to CMA, who had at onset of diarrhea RAST and/or skin tests positive to cow's milk. After the diarrhea subsided, the diet was continued for 6 months and, subsequently, cow's milk reintroduction was attempted at 6-month intervals. In contrast to 25/37 children (four cases were lost to follow-up) in whom CMA subsided at a median age of 2 years, 12/37 (32.5%) children did not tolerate cow's milk at a median age of 6 years. In addition, a large proportion of children (27/37 = 73%) suffered during the follow-up period from other atopic manifestations, due either to CMA or to inhalant allergy. Our data suggest that in infants with chronic diarrhea due to CMA, RAST and/or skin tests positive to cow's milk may indicate either the tendency of CMA to persist throughout childhood, or the risk of developing other atopic diseases.
D000818:Animals; D002417:Cattle; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications* / Q000209:etiology; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D008297:Male; D008892:Milk / Q000009:adverse effects; D011852:Radioallergosorbent Test; D012130:Respiratory Hypersensitivity / Q000150:complications; D012882:Skin Tests