Incidence and natural history of challenge‐proven cow's milk allergy in European children – EuroPrevall birth cohort
Background Cow's milk allergy (CMA) is one of the most commonly reported childhood food problems. Community‐based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria. M...
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| Veröffentlicht in: | Allergy (Copenhagen) 2015-08, Vol.70 (8), p.963-972 |
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| creator | Schoemaker, A. A. Sprikkelman, A. B. Grimshaw, K. E. Roberts, G. Grabenhenrich, L. Rosenfeld, L. Siegert, S. Dubakiene, R. Rudzeviciene, O. Reche, M. Fiandor, A. Papadopoulos, N. G. Malamitsi‐Puchner, A. Fiocchi, A. Dahdah, L. Sigurdardottir, S. Th Clausen, M. Stańczyk‐Przyłuska, A. Zeman, K. Mills, E. N. C. McBride, D. Keil, T. Beyer, K. |
| description | Background
Cow's milk allergy (CMA) is one of the most commonly reported childhood food problems. Community‐based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria.
Methods
Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cows' milk‐specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double‐blind, placebo‐controlled food challenge.
Results
Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge‐proven CMA of 0.54% (95% CI 0.41–0.70). National incidences ranged from 1% (in the Netherlands and UK) to |
| doi_str_mv | 10.1111/all.12630 |
| format | Article |
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Cow's milk allergy (CMA) is one of the most commonly reported childhood food problems. Community‐based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria.
Methods
Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cows' milk‐specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double‐blind, placebo‐controlled food challenge.
Results
Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge‐proven CMA of 0.54% (95% CI 0.41–0.70). National incidences ranged from 1% (in the Netherlands and UK) to <0.3% (in Lithuania, Germany and Greece). Of all children with CMA, 23.6% had no cow's milk‐specific IgE in serum, especially those from UK, the Netherlands, Poland and Italy. Of children with CMA who were re‐evaluated one year after diagnosis, 69% (22/32) tolerated cow's milk, including all children with non‐IgE‐associated CMA and 57% of those children with IgE‐associated CMA.
Conclusions
This unique pan‐European birth cohort study using the gold standard diagnostic procedure for food allergies confirmed challenge‐proven CMA in <1% of children up to age 2. Affected infants without detectable specific antibodies to cow's milk were very likely to tolerate cow's milk one year after diagnosis, whereas only half of those with specific antibodies in serum ‘outgrew’ their disease so soon.</description><identifier>ISSN: 0105-4538</identifier><identifier>EISSN: 1398-9995</identifier><identifier>DOI: 10.1111/all.12630</identifier><identifier>PMID: 25864712</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Age Distribution ; Allergens - immunology ; Animals ; birth cohort study ; Cattle ; Child ; Child, Preschool ; Children & youth ; Cohort Studies ; cow's milk allergy ; Double-Blind Method ; Europe - epidemiology ; EuroPrevall ; Female ; Food allergies ; food allergy ; Humans ; Immunoglobulin E - immunology ; Incidence ; Infant ; Male ; Milk ; Milk Hypersensitivity - diagnosis ; Milk Hypersensitivity - epidemiology ; Milk Proteins - adverse effects ; Milk Proteins - immunology ; Severity of Illness Index ; Sex Distribution ; Skin Tests - methods</subject><ispartof>Allergy (Copenhagen), 2015-08, Vol.70 (8), p.963-972</ispartof><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4890-e5f4b513ed956f8b22e020d4627e2962b0adba22cb7ba0f7a8c3cc8976d64c3d3</citedby><cites>FETCH-LOGICAL-c4890-e5f4b513ed956f8b22e020d4627e2962b0adba22cb7ba0f7a8c3cc8976d64c3d3</cites><orcidid>0000-0003-3649-7963</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fall.12630$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fall.12630$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25864712$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schoemaker, A. A.</creatorcontrib><creatorcontrib>Sprikkelman, A. B.</creatorcontrib><creatorcontrib>Grimshaw, K. E.</creatorcontrib><creatorcontrib>Roberts, G.</creatorcontrib><creatorcontrib>Grabenhenrich, L.</creatorcontrib><creatorcontrib>Rosenfeld, L.</creatorcontrib><creatorcontrib>Siegert, S.</creatorcontrib><creatorcontrib>Dubakiene, R.</creatorcontrib><creatorcontrib>Rudzeviciene, O.</creatorcontrib><creatorcontrib>Reche, M.</creatorcontrib><creatorcontrib>Fiandor, A.</creatorcontrib><creatorcontrib>Papadopoulos, N. G.</creatorcontrib><creatorcontrib>Malamitsi‐Puchner, A.</creatorcontrib><creatorcontrib>Fiocchi, A.</creatorcontrib><creatorcontrib>Dahdah, L.</creatorcontrib><creatorcontrib>Sigurdardottir, S. Th</creatorcontrib><creatorcontrib>Clausen, M.</creatorcontrib><creatorcontrib>Stańczyk‐Przyłuska, A.</creatorcontrib><creatorcontrib>Zeman, K.</creatorcontrib><creatorcontrib>Mills, E. N. C.</creatorcontrib><creatorcontrib>McBride, D.</creatorcontrib><creatorcontrib>Keil, T.</creatorcontrib><creatorcontrib>Beyer, K.</creatorcontrib><title>Incidence and natural history of challenge‐proven cow's milk allergy in European children – EuroPrevall birth cohort</title><title>Allergy (Copenhagen)</title><addtitle>Allergy</addtitle><description>Background
Cow's milk allergy (CMA) is one of the most commonly reported childhood food problems. Community‐based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria.
Methods
Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cows' milk‐specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double‐blind, placebo‐controlled food challenge.
Results
Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge‐proven CMA of 0.54% (95% CI 0.41–0.70). National incidences ranged from 1% (in the Netherlands and UK) to <0.3% (in Lithuania, Germany and Greece). Of all children with CMA, 23.6% had no cow's milk‐specific IgE in serum, especially those from UK, the Netherlands, Poland and Italy. Of children with CMA who were re‐evaluated one year after diagnosis, 69% (22/32) tolerated cow's milk, including all children with non‐IgE‐associated CMA and 57% of those children with IgE‐associated CMA.
Conclusions
This unique pan‐European birth cohort study using the gold standard diagnostic procedure for food allergies confirmed challenge‐proven CMA in <1% of children up to age 2. Affected infants without detectable specific antibodies to cow's milk were very likely to tolerate cow's milk one year after diagnosis, whereas only half of those with specific antibodies in serum ‘outgrew’ their disease so soon.</description><subject>Age Distribution</subject><subject>Allergens - immunology</subject><subject>Animals</subject><subject>birth cohort study</subject><subject>Cattle</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Cohort Studies</subject><subject>cow's milk allergy</subject><subject>Double-Blind Method</subject><subject>Europe - epidemiology</subject><subject>EuroPrevall</subject><subject>Female</subject><subject>Food allergies</subject><subject>food allergy</subject><subject>Humans</subject><subject>Immunoglobulin E - immunology</subject><subject>Incidence</subject><subject>Infant</subject><subject>Male</subject><subject>Milk</subject><subject>Milk Hypersensitivity - diagnosis</subject><subject>Milk Hypersensitivity - epidemiology</subject><subject>Milk Proteins - adverse effects</subject><subject>Milk Proteins - immunology</subject><subject>Severity of Illness Index</subject><subject>Sex Distribution</subject><subject>Skin Tests - methods</subject><issn>0105-4538</issn><issn>1398-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLFOwzAQhi0EoqUw8ALIEgNiSGs7iROPVVWgUiQYYI4c22lS0qTYSUu2PgISb9gnwW0KG15O8n333ekH4BqjIbZvxItiiAl10QnoY5eFDmPMPwV9hJHveL4b9sCFMQuEUEAYOgc94ofUCzDpg89ZKXKpSqEgLyUsed1oXsAsN3WlW1ilUGRWr8q52m2_VrpaqxKKanNn4DIv3uG-p-ctzEs4bXS1Uty2s7yQ2nK77ffh90WrtQVhkus6s9NZpetLcJbywqirYx2At4fp6-TJiZ4fZ5Nx5AgvZMhRfuolPnaVZD5Nw4QQhQiSHiWBIoySBHGZcEJEEiQcpQEPhStEyAIqqSdc6Q7Abee1t380ytTxomp0aVfGmDKGPZ8iz1L3HSV0ZYxWabzS-ZLrNsYo3mcc2_vjQ8aWvTkam2Sp5B_5G6oFRh2wyQvV_m-Kx1HUKX8A6MuI-w</recordid><startdate>201508</startdate><enddate>201508</enddate><creator>Schoemaker, A. A.</creator><creator>Sprikkelman, A. B.</creator><creator>Grimshaw, K. E.</creator><creator>Roberts, G.</creator><creator>Grabenhenrich, L.</creator><creator>Rosenfeld, L.</creator><creator>Siegert, S.</creator><creator>Dubakiene, R.</creator><creator>Rudzeviciene, O.</creator><creator>Reche, M.</creator><creator>Fiandor, A.</creator><creator>Papadopoulos, N. G.</creator><creator>Malamitsi‐Puchner, A.</creator><creator>Fiocchi, A.</creator><creator>Dahdah, L.</creator><creator>Sigurdardottir, S. Th</creator><creator>Clausen, M.</creator><creator>Stańczyk‐Przyłuska, A.</creator><creator>Zeman, K.</creator><creator>Mills, E. N. C.</creator><creator>McBride, D.</creator><creator>Keil, T.</creator><creator>Beyer, K.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0003-3649-7963</orcidid></search><sort><creationdate>201508</creationdate><title>Incidence and natural history of challenge‐proven cow's milk allergy in European children – EuroPrevall birth cohort</title><author>Schoemaker, A. A. ; Sprikkelman, A. B. ; Grimshaw, K. E. ; Roberts, G. ; Grabenhenrich, L. ; Rosenfeld, L. ; Siegert, S. ; Dubakiene, R. ; Rudzeviciene, O. ; Reche, M. ; Fiandor, A. ; Papadopoulos, N. G. ; Malamitsi‐Puchner, A. ; Fiocchi, A. ; Dahdah, L. ; Sigurdardottir, S. Th ; Clausen, M. ; Stańczyk‐Przyłuska, A. ; Zeman, K. ; Mills, E. N. C. ; McBride, D. ; Keil, T. ; Beyer, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4890-e5f4b513ed956f8b22e020d4627e2962b0adba22cb7ba0f7a8c3cc8976d64c3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Age Distribution</topic><topic>Allergens - immunology</topic><topic>Animals</topic><topic>birth cohort study</topic><topic>Cattle</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Cohort Studies</topic><topic>cow's milk allergy</topic><topic>Double-Blind Method</topic><topic>Europe - epidemiology</topic><topic>EuroPrevall</topic><topic>Female</topic><topic>Food allergies</topic><topic>food allergy</topic><topic>Humans</topic><topic>Immunoglobulin E - immunology</topic><topic>Incidence</topic><topic>Infant</topic><topic>Male</topic><topic>Milk</topic><topic>Milk Hypersensitivity - diagnosis</topic><topic>Milk Hypersensitivity - epidemiology</topic><topic>Milk Proteins - adverse effects</topic><topic>Milk Proteins - immunology</topic><topic>Severity of Illness Index</topic><topic>Sex Distribution</topic><topic>Skin Tests - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schoemaker, A. A.</creatorcontrib><creatorcontrib>Sprikkelman, A. B.</creatorcontrib><creatorcontrib>Grimshaw, K. E.</creatorcontrib><creatorcontrib>Roberts, G.</creatorcontrib><creatorcontrib>Grabenhenrich, L.</creatorcontrib><creatorcontrib>Rosenfeld, L.</creatorcontrib><creatorcontrib>Siegert, S.</creatorcontrib><creatorcontrib>Dubakiene, R.</creatorcontrib><creatorcontrib>Rudzeviciene, O.</creatorcontrib><creatorcontrib>Reche, M.</creatorcontrib><creatorcontrib>Fiandor, A.</creatorcontrib><creatorcontrib>Papadopoulos, N. G.</creatorcontrib><creatorcontrib>Malamitsi‐Puchner, A.</creatorcontrib><creatorcontrib>Fiocchi, A.</creatorcontrib><creatorcontrib>Dahdah, L.</creatorcontrib><creatorcontrib>Sigurdardottir, S. Th</creatorcontrib><creatorcontrib>Clausen, M.</creatorcontrib><creatorcontrib>Stańczyk‐Przyłuska, A.</creatorcontrib><creatorcontrib>Zeman, K.</creatorcontrib><creatorcontrib>Mills, E. N. C.</creatorcontrib><creatorcontrib>McBride, D.</creatorcontrib><creatorcontrib>Keil, T.</creatorcontrib><creatorcontrib>Beyer, K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Allergy (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schoemaker, A. A.</au><au>Sprikkelman, A. B.</au><au>Grimshaw, K. E.</au><au>Roberts, G.</au><au>Grabenhenrich, L.</au><au>Rosenfeld, L.</au><au>Siegert, S.</au><au>Dubakiene, R.</au><au>Rudzeviciene, O.</au><au>Reche, M.</au><au>Fiandor, A.</au><au>Papadopoulos, N. G.</au><au>Malamitsi‐Puchner, A.</au><au>Fiocchi, A.</au><au>Dahdah, L.</au><au>Sigurdardottir, S. Th</au><au>Clausen, M.</au><au>Stańczyk‐Przyłuska, A.</au><au>Zeman, K.</au><au>Mills, E. N. C.</au><au>McBride, D.</au><au>Keil, T.</au><au>Beyer, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and natural history of challenge‐proven cow's milk allergy in European children – EuroPrevall birth cohort</atitle><jtitle>Allergy (Copenhagen)</jtitle><addtitle>Allergy</addtitle><date>2015-08</date><risdate>2015</risdate><volume>70</volume><issue>8</issue><spage>963</spage><epage>972</epage><pages>963-972</pages><issn>0105-4538</issn><eissn>1398-9995</eissn><abstract>Background
Cow's milk allergy (CMA) is one of the most commonly reported childhood food problems. Community‐based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria.
Methods
Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cows' milk‐specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double‐blind, placebo‐controlled food challenge.
Results
Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge‐proven CMA of 0.54% (95% CI 0.41–0.70). National incidences ranged from 1% (in the Netherlands and UK) to <0.3% (in Lithuania, Germany and Greece). Of all children with CMA, 23.6% had no cow's milk‐specific IgE in serum, especially those from UK, the Netherlands, Poland and Italy. Of children with CMA who were re‐evaluated one year after diagnosis, 69% (22/32) tolerated cow's milk, including all children with non‐IgE‐associated CMA and 57% of those children with IgE‐associated CMA.
Conclusions
This unique pan‐European birth cohort study using the gold standard diagnostic procedure for food allergies confirmed challenge‐proven CMA in <1% of children up to age 2. Affected infants without detectable specific antibodies to cow's milk were very likely to tolerate cow's milk one year after diagnosis, whereas only half of those with specific antibodies in serum ‘outgrew’ their disease so soon.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>25864712</pmid><doi>10.1111/all.12630</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3649-7963</orcidid></addata></record> |
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| ispartof | Allergy (Copenhagen), 2015-08, Vol.70 (8), p.963-972 |
| issn | 0105-4538 1398-9995 |
| language | eng |
| recordid | cdi_proquest_journals_1699145604 |
| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Age Distribution Allergens - immunology Animals birth cohort study Cattle Child Child, Preschool Children & youth Cohort Studies cow's milk allergy Double-Blind Method Europe - epidemiology EuroPrevall Female Food allergies food allergy Humans Immunoglobulin E - immunology Incidence Infant Male Milk Milk Hypersensitivity - diagnosis Milk Hypersensitivity - epidemiology Milk Proteins - adverse effects Milk Proteins - immunology Severity of Illness Index Sex Distribution Skin Tests - methods |
| title | Incidence and natural history of challenge‐proven cow's milk allergy in European children – EuroPrevall birth cohort |
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