title: Efficacy and safety of oral desensitization in children with cow's milk allergy according to their serum specific IgE level.
abstract: BACKGROUND
  Oral desensitization in children allergic to cow's milk proteins is not risk free. The analysis of factors that may influence the outcome is of utmost importance.
  
  
  OBJECTIVE
  To analyze the efficacy and safety of the oral desensitization according to specific IgE (sIgE) level and adverse events during the maintenance phase.
  
  
  METHODS
  Thirty-six patients allergic to cow's milk (mean age, 7 years) were included in an oral desensitization protocol. Patients were grouped according to sIgE levels (ImmunoCAP) into groups 1 (sIgE <3.5 kU/L), 2 (3.5-17 kU/L), and 3 (>17-50 kU/L). Nineteen children were included as a control group. Serum sIgE levels to cow's milk and its proteins were determined at inclusion and 6 and 12 months after finishing the desensitization protocol.
  
  
  RESULTS
  Thirty-three of 36 patients were successfully desensitized (200 mL): 100% of group 1 and 88% of groups 2 and 3. Desensitization was achieved in a median of 3 months (range, 1-12 months); 90% of the patients in group 1, 50% of the patients in group 2, and 30% of the patients in group 3 achieved tolerance in less than 3 months (P = .04). In the control group only 1 child tolerated milk in oral food challenge after 1 year. During the induction phase, there were 53 adverse events in 27 patients (75%). Patients of groups 2 and 3 had more severe adverse events compared with group 1. During the maintenance phase, 20 of 33 patients (60%) had an adverse event.
  
  
  CONCLUSIONS
  Oral desensitization is efficacious. Tolerance is achieved earlier when sIgE is lower. Severe adverse events are frequent, especially in patients with higher sIgE levels.
authors.affiliation: Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: García-Ara
authors.forename: María
authors.initials: M
authors.lastname: Pedrosa
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Belver
authors.forename: María Flor
authors.initials: MF
authors.lastname: Martín-Muñoz
authors.forename: Santiago
authors.initials: S
authors.lastname: Quirce
authors.forename: Teresa
authors.initials: T
authors.lastname: Boyano-Martínez
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D008892:Milk / Q000009:adverse effects / Q000276:immunology; D016269:Milk Hypersensitivity / Q000276:immunology / Q000628:therapy*; D008894:Milk Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D008894:Milk Proteins; D007073:Immunoglobulin E