title: Oral desensitization as a useful treatment in 2-year-old children with cow's milk allergy.
abstract: BACKGROUND
  Limited published evidence shows oral desensitization to be a potential intervention option for cow's milk protein (CMPs) allergy.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy of oral desensitization in 2-year-old children with cow's milk allergy, as a treatment alternative to elimination diet.
  
  
  METHODS
  A total of 60 children aged 24-36 months with IgE-mediated allergy to CMPs were included in this multi-center study and were randomized into two groups. Thirty children (group A: treatment group) began oral desensitization immediately, whereas the remaining 30 (group B: control group) were kept on a milk-free diet and followed-up for 1 year.
  
  
  RESULTS
  After 1-year follow-up period, 90% of the children in group A had become completely tolerant vs. 23% of the children in group B. In group A, cow's milk skin reactivity and serum-specific IgE to milk and casein decreased significantly from the initial assessment, whereas group B showed no significant change after 1 year of follow-up. Twenty-four patients (80%) developed some reaction during the treatment period: 14 children developed moderate reaction (47%) and 10 mild reaction (33%). The most common manifestations were urticaria-angioedema, followed by cough.
  
  
  CONCLUSIONS
  In this study, oral desensitization was found to be effective in a significant percentage of 2-year-old children with cow's milk allergy. Oral desensitization appears to be efficacious as an alternative to elimination diet in the treatment of 2-year-old children with cow's milk allergy. The side-effect profile appears acceptable but requires further study.
authors.affiliation: Hospital General Universitario, Unidad de Alergología, Valencia, Spain. martorell_ant@gva.es
authors.forename: A
authors.initials: A
authors.lastname: Martorell
authors.forename: B
authors.initials: B
authors.lastname: De la Hoz
authors.forename: M D
authors.initials: MD
authors.lastname: Ibáñez
authors.forename: J
authors.initials: J
authors.lastname: Bone
authors.forename: M S
authors.initials: MS
authors.lastname: Terrados
authors.forename: A
authors.initials: A
authors.lastname: Michavila
authors.forename: A M
authors.initials: AM
authors.lastname: Plaza
authors.forename: E
authors.initials: E
authors.lastname: Alonso
authors.forename: J
authors.initials: J
authors.lastname: Garde
authors.forename: S
authors.initials: S
authors.lastname: Nevot
authors.forename: L
authors.initials: L
authors.lastname: Echeverria
authors.forename: C
authors.initials: C
authors.lastname: Santana
authors.forename: J C
authors.initials: JC
authors.lastname: Cerdá
authors.forename: C
authors.initials: C
authors.lastname: Escudero
authors.forename: I
authors.initials: I
authors.lastname: Guallar
authors.forename: M
authors.initials: M
authors.lastname: Piquer
authors.forename: L
authors.initials: L
authors.lastname: Zapatero
authors.forename: L
authors.initials: L
authors.lastname: Ferré
authors.forename: T
authors.initials: T
authors.lastname: Bracamonte
authors.forename: A
authors.initials: A
authors.lastname: Muriel
authors.forename: M I
authors.initials: MI
authors.lastname: Martínez
authors.forename: R
authors.initials: R
authors.lastname: Félix
mesh_terms: D000284:Administration, Oral; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000009:adverse effects; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D016269:Milk Hypersensitivity / Q000097:blood / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D007073:Immunoglobulin E