title: Cow's milk elimination: a novel dietary approach to treat eosinophilic esophagitis.
abstract: OBJECTIVE
  Cow's-milk protein is one of the food antigens responsible for causing eosinophilic esophageal inflammation in a majority of children. We describe our experience with treating eosinophilic esophagitis (EoE) in children by eliminating only cow's milk from their diets.
  
  
  METHODS
  This retrospective study assessed the short-term clinical and histological response to eliminating cow's-milk protein from the diet of children with EoE. Only patients undergoing a subsequent upper endoscopy to assess their histological response were included in this analysis.
  
  
  RESULTS
  We identified 17 (12 boys and 5 girls) children with EoE who excluded only cow's milk from their diet. Remission was induced in 11 of 17 (65%) patients; within the remission group, 7 (41%) achieved complete histological remission and 4 patients (24%) were in significant histological remission. The mean peak pre- and posttreatment counts for those in remission were 76 ± 40 and 2 ± 4 (P < 0.01), respectively.
  
  
  CONCLUSIONS
  Elimination of cow's milk-induced clinical and histological remission in 65% (95% confidence interval 42%-88%) of children with EoE in whom it was attempted. This approach offers distinct advantages over other dietary treatment approaches for the initial management of children with EoE. The role of eliminating cow's milk alone for the treatment of EoE warrants further prospective study.
authors: Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. akagalwalla@luriechildrens.org
authors: Amir F
authors: AF
authors: Kagalwalla
authors: Katie
authors: K
authors: Amsden
authors: Ameesh
authors: A
authors: Shah
authors: Sally
authors: S
authors: Ritz
authors: Maria
authors: M
authors: Manuel-Rubio
authors: Katherine
authors: K
authors: Dunne
authors: Suzanne P
authors: SP
authors: Nelson
authors: Barry K
authors: BK
authors: Wershil
authors: Hector
authors: H
authors: Melin-Aldana
mesh_terms: D000293:Adolescent; D000818:Animals; D002417:Cattle; D002648:Child; D057765:Eosinophilic Esophagitis / Q000178:diet therapy* / Q000209:etiology / Q000276:immunology / Q000473:pathology; D004804:Eosinophils / Q000378:metabolism*; D004945:Esophagoscopy; D004947:Esophagus / Q000276:immunology / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D007958:Leukocyte Count; D008297:Male; D008892:Milk / Q000276:immunology*; D016269:Milk Hypersensitivity / Q000150:complications / Q000178:diet therapy* / Q000276:immunology / Q000473:pathology; D008894:Milk Proteins / Q000276:immunology; D012074:Remission Induction; D012189:Retrospective Studies
chemical_list: D008894:Milk Proteins