title: Is it just lactose intolerance?
abstract: Acquired delayed-onset hypolactasia is a common autosomal recessive condition. Cow's milk allergies, conversely, are less common conditions that may manifest with equivalent symptoms and are able to simulate and/or aggravate lactose intolerance. This study was designed to evaluate the  contribution of IgE-mediated cow's milk sensitization to the symptomatology of adult patients with lactose-free diet refractory lactose intolerance. Forty-six adult patients with lactose intolerance and persistent symptoms despite a lactose-free diet underwent skin-prick test to investigate  cow's milk, goat's milk, and soy protein-specific-IgE. SDS-PAGE immunoblotting was used to investigate the presence of cow's milk protein-specific IgE. The percentage of patients who had skin reactions to whole cow's milk, alpha-lactalbumin, beta-lactoglobulin, caseins, goat's  milk, and soy was 69.5, 36.9, 56.5, 56.5%, 54.3, and 50%, respectively. The percentage of patients with immunoblot-detected IgE specific for alpha-lactalbumin, beta-lactoglobulin, caseins, and bovine serum albumin was 21.7, 63, 67.3, and 2.1%, respectively. IgE-mediated sensitization to cow's  milk is a frequent comorbidity in subjects with lactose-free diet refractory lactose intolerance and is worth consideration in patients with this condition.
authors.affiliation: Laboratory of Allergy and Experimental Immunology, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Celso Eduardo
authors.initials: CE
authors.lastname: Olivier
authors.forename: Sônia Letícia Silva
authors.initials: SL
authors.lastname: Lorena
authors.forename: Célia Regina
authors.initials: CR
authors.lastname: Pavan
authors.forename: Raquel Acácia Pereira Gonçalves
authors.initials: RA
authors.lastname: dos Santos
authors.forename: Regiane Patussi
authors.initials: RP
authors.lastname: dos Santos Lima
authors.forename: Daiana Guedes
authors.initials: DG
authors.lastname: Pinto
authors.forename: Mariana Dias
authors.initials: MD
authors.lastname: da Silva
authors.forename: Ricardo
authors.initials: R
authors.lastname: de Lima Zollner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002417:Cattle; D005260:Female; D006041:Goats; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood*; D007787:Lactose Intolerance / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000276:immunology; D016269:Milk Hypersensitivity / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D008894:Milk Proteins / Q000737:chemistry / Q000276:immunology*; D012882:Skin Tests; D030262:Soybean Proteins / Q000276:immunology; D055815:Young Adult
chemical_list: D008894:Milk Proteins; D030262:Soybean Proteins; D007073:Immunoglobulin E