title: Feeding a soy formula to children with cow's milk allergy: the development of immunoglobulin E-mediated allergy to soy and peanuts.
abstract: Peanut allergy has been associated with the intake of soy milk or a soy formula. We studied the development of immunoglobulin E antibodies specific to soy and peanuts and of allergic reactions caused by peanuts, in children with confirmed cow's milk (CM) allergy fed either a soy formula or an extensively hydrolyzed formula (EHF). One hundred and seventy infants with documented CM allergy (CMA) were randomly assigned to receive either a soy formula or an EHF. The children were followed to the age of 4 yr. Peanut-specific immunoglobulin E was measured at the age of 4. A detailed history of the occurrence of allergic reactions caused by peanuts was recorded by the parents. Soy-specific immunoglobulin E antibodies were measured at the time of diagnosis and at the ages of 1, 2 and 4 yr. Immunoglobulin E antibodies to soy (> or =0.35 kU/l) were found in 22 of 70 children fed the soy formula, and in 14 of 70 of the children fed the EHF (p = 0.082). In an open challenge with soy at the age of 4, no immediate reactions were observed. One of 72 children from the soy group had a delayed reaction. immunoglobulin E antibodies to peanuts (> or =0.35 kU/l) were found in 21 of 70 children fed the soy formula and 17 of 69 infants fed the EHF (p = 0.717). The incidence of reported peanut allergy in the soy group was two of 72 (3%) and four of 76 (5%) in the EHF group (p = 0.68). Development of immunoglobulin E-associated allergy to soy and peanuts was rare in our study group of milk allergic children. The use of a soy formula during the first 2 yr of life did not increase the risk of development of peanut-specific immunoglobulin E antibodies or of clinical peanut allergy.
authors.affiliation: Jorvi Hospital, Department of Pediatrics, Espoo, Finland. timo.klemola@hus.fi
authors.forename: Timo
authors.initials: T
authors.lastname: Klemola
authors.forename: Kirsti
authors.initials: K
authors.lastname: Kalimo
authors.forename: Tuija
authors.initials: T
authors.lastname: Poussa
authors.forename: Kaisu
authors.initials: K
authors.lastname: Juntunen-Backman
authors.forename: Riitta
authors.initials: R
authors.lastname: Korpela
authors.forename: Erkka
authors.initials: E
authors.lastname: Valovirta
authors.forename: Timo
authors.initials: T
authors.lastname: Vanto
mesh_terms: D010367:Arachis / Q000009:adverse effects / Q000276:immunology; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D006801:Humans; D006868:Hydrolysis; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage* / Q000737:chemistry; D008297:Male; D016269:Milk Hypersensitivity / Q000517:prevention & control*; D021183:Peanut Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D011446:Prospective Studies; D030262:Soybean Proteins / Q000009:adverse effects* / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D030262:Soybean Proteins; D007073:Immunoglobulin E