title: Natural course and risk factors for persistence of IgE-mediated cow's milk allergy.
abstract: OBJECTIVE
  To describe the natural course of IgE-mediated cow's milk allergy (IgE-CMA) and to determine risk factors for its persistence in a population-based cohort.
  
  
  METHODS
  In a prospective cohort study, 54 infants with IgE-CMA were identified from a population of 13 019 children followed from birth. Diagnosis of IgE-CMA was based on history, skin prick test (SPT), and an oral food challenge (OFC) when indicated. Allergic infants were followed for 48-60 months. Families were contacted by telephone every 6 months and asked about recent exposures to milk. OFC was repeated to evaluate for recovery. Clinical characteristics, SPT, and OFC outcomes were compared between infants with persistent IgE-CMA and infants who recovered.
  
  
  RESULTS
  Thirty-one infants (57.4%) recovered from IgE-CMA during the study period. Most infants (70.9%) recovered within the first 2 years. Risk factors for persistence on multivariate analysis included a reaction to <10 mL of milk on OFC (or on first exposure as estimated by the guardian, if OFC was not performed) (P = .01), a larger wheal size on SPT (P = .014), and age of ≤30 days at time of first reaction (P = .05).
  
  
  CONCLUSIONS
  Resolution occurs in most infants with IgE-CMA. Infants reacting to <10 mL of milk or in the first month of life, and those with a larger wheal size on SPT, are at increased risk for persistence.
authors.affiliation: Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Elizur
authors.forename: Nelly
authors.initials: N
authors.lastname: Rajuan
authors.forename: Michael R
authors.initials: MR
authors.lastname: Goldberg
authors.forename: Moshe
authors.initials: M
authors.lastname: Leshno
authors.forename: Adi
authors.initials: A
authors.lastname: Cohen
authors.forename: Yitzhak
authors.initials: Y
authors.lastname: Katz
mesh_terms: D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D007223:Infant; D016269:Milk Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D007073:Immunoglobulin E