title: [Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein].
abstract: BACKGROUND
  Cow's milk protein allergy (CMPA) is highly prevalent in infants (2-5%). It has a wide clinical spectrum, and confirmation through an oral food challenge (OFC) is relevant for its differential diagnosis. Information on this topic is scarce in Chile.
  
  
  OBJECTIVE
  To describe the demographic and clinical features of infants with suspected CMPA.
  
  
  METHODS
  A retrospective study of patients<1 year-old, treated for suspected CMPA between 2009 and 2011. Demographic data, symptoms of atopy, nutrition at the time of diagnosis, CMPA symptoms, diagnostic studies, and response to treatment were recorded. Diet response at least 4 weeks after milk modification, and clinical behavior when suspected foods were added back to the diet were considered standard diagnostic criteria. Descriptive statistics were performed using Epiinfo ™ software.
  
  
  RESULTS
  The study included 106 infants, of whom, 51% male, 80% term newborns, 74% with≥1 atopic parent, and 34% with ≥1 parent/sibling with food allergy. The median age at onset of symptoms was 1.5 months (range 1.5-2m). Almost half (46%) were breast-feeding≥6m, with 15% receiving formula milk since the neonatal period, and 49% before the third month. Common symptoms were: vomiting (63%), colic (49%), and bleeding on passing stools (41%). No anaphylaxis was identified, and 61% had≥2 symptoms at debut. Only 34% were subjected to OFC. The most frequently requested tests were, test patch (43%), prick test (40%), and blood in stools (37%).
  
  
  METHODS
  43% breast feeding with exclusion diet, 24% extensively hydrolysed formula, 26% amino acid formula, and 7% others.
  
  
  CONCLUSIONS
  Demographic characteristics and risk factors were similar to those previously described in international literature. Clinical presentation was early in life, and digestive symptoms predominated. OFC was underused for diagnosis, and most of the tests requested did not change management.
authors.affiliation: Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile. Electronic address: gerrazuriz@clc.cl.
authors.forename: Germán
authors.initials: G
authors.lastname: Errázuriz
authors.affiliation: Unidad de Gastroenterología, Departamento de Pediatría y Cirugía Infantil Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Lucero
authors.affiliation: Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ceresa
authors.affiliation: Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
authors.forename: Mónica
authors.initials: M
authors.lastname: Gonzalez
authors.affiliation: Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
authors.forename: Maureen
authors.initials: M
authors.lastname: Rossel
authors.affiliation: Unidad de Gastroenterología, Departamento de Pediatría, Clínica Las Condes, Santiago, Chile.
authors.forename: Andrés
authors.initials: A
authors.lastname: Vives
mesh_terms: D001942:Breast Feeding; D002677:Chile; D003085:Colic / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology; D008894:Milk Proteins / Q000009:adverse effects* / Q000276:immunology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology*
chemical_list: D008894:Milk Proteins
keywords: Alergia a proteína de leche de vaca; Alergia alimentaria; Allergic proctocolitis; Colic; Cow's milk allergy; Cólico; Food allergy; Gastroesophageal reflux disease; Proctocolitis alérgica; Reflujo gastroesofágico patológico