Successful management of severe cow's milk allergy with omalizumab treatment and CD-sens monitoring.
Food allergy is common in children and young adults and may be difficult to diagnose and is at present treated with avoidance of the food in question. The aim of this report is to share our clinical experiences monitoring omalizumab treatment by basophil allergen threshold sensitivity, CD-sens. Five children, 6-16 years of age, with a severe milk allergy including episodes of anaphylaxis and IgE-antibodies, between 30 and 160 kUA/L to casein and alpha-lactalbumin (milk proteins), were treated with omalizumab. CD-sens, was tested prior to and after 4 months of omalizumab and if turned negative, it was followed by an oral milk challenge. All children became negative in CD-sens and had a negative milk challenge, but one child required doubling of the omalizumab dose to achieve a negative CD-sens before a challenge was done. Omalizumab appears useful in treatment of severe food allergy, e.g., anaphylaxis to milk, and CD-sens monitoring may decide when and how to perform a food challenge.
Department of Clinical Science and Education, Södersjukhuset, Centre for Allergy Research, Karolinska Institutet and Sach's Children's Hospital, Södersjukhuset, 118 83 Stockholm, Sweden.
Caroline
C
Nilsson
Department of Women's and Children's Health, Uppsala University Hospital, 751 85 Uppsala, Sweden.
Lennart
L
Nordvall
Department of Medicine, Clinical Immunology and Allergy Unit, Karolinska Institutet and University Hospital, 171 76 Stockholm, Sweden.
S G O
SG
Johansson
Department of Medicine, Clinical Immunology and Allergy Unit, Karolinska Institutet and University Hospital, 171 76 Stockholm, Sweden.
Anna
A
Nopp
Anaphylaxis; Basophil; Child; Food hypersensitivity; Omalizumab