Oral Immunotherapy for Cow's Milk Allergy: Five Years' Experience from a Single Center in Turkey

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dc.authorscopusid7004473191
dc.authorscopusid37092966400
dc.authorscopusid9036191300
dc.authorscopusid6602303657
dc.contributor.authorDemir, Esen
dc.contributor.authorGünaydın, Nurşen Ciğerci
dc.contributor.authorGülen, Figen
dc.contributor.authorTanac, Remziye
dc.date.accessioned2022-05-11T14:37:15Z
dc.date.available2022-05-11T14:37:15Z
dc.date.issued2020
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground: Oral immunotherapy for cow's milk allergy is an effective treatment option because of its ability to increase the threshold for clinical reactions. Aims: To present our experience of oral immunotherapy for cow's milk allergy in the pediatric allergy outpatient clinic, and to evaluate the long-term efficacy of oral immunotherapy and risk factors for adverse reactions during oral immunotherapy. Study Design: Single-center retrospective cohort study. Methods: Forty-two patients with Immunoglobtilin-E-mediated cow's milk allergy who complied with the oral immunotherapy protocol were evaluated in this study. The treatment consisted of a rapid escalation phase with an oral food challenge step that included milk doses. During the build-up phase, increasing quantities of cow's milk were administered until the patient was able to consume 200 mL of cow's milk daily. Results: The mean age of starting the oral immunotherapy was 40.2 +/- 3.2(range. 36-156) months. and 54.8% (n=23) of the patients were males. The mean duration of the build-up phase was 18.1 +/- 5.6 (range. 9-41) weeks, and the mean maintenance phase was 29.1 +/- 11.6 range. 12-63) months. During the oral immunotherapy, 36 adverse reactions (78% mild and 22%; moderate) occurred in 16 (38%) patients. There were no differences in the age of starting the oral immunotherapy (p=0.19), cow's milk-specific Immunoglobulin-F, levels (p=0.17), and cumulative provocative doses of oral food challenges (p=0.78) between the mo groups of patients with and without adverse reactions. The wheal diameters to cow's milk were higher in the group with adverse reactions (p=0.03). There was no difference in the oral immunotherapy onset age between patients with and without a history of anaphylaxis (p=0.38). The patients with a history of anaphylaxis had more adverse reactions (p-0.04) and a higher number of reactions during the oral immunotherapy (p=0.01), and a higher mean duration of the up-dosing phase (p=0.04) compared with patients without anaphylaxis. Conclusion: Oral immunotherapy is a treatment option in patients with cow's milk allergy because of its high efficacy. Adverse reactions occur in about 40% of cases and are mostly mild. It should be administered with caution to patients with a history of anaphylaxis and a higher wheal diameter to cow's milk in the skin prick test.
dc.identifier.doi10.4274/balkanmedj.galenos.2020.2020.1.140
dc.identifier.endpage323
dc.identifier.issn2146-3123
dc.identifier.issn2146-3131
dc.identifier.issue6en_US
dc.identifier.pmid32648410
dc.identifier.scopus2-s2.0-85093961639
dc.identifier.scopusqualityQ3
dc.identifier.startpage316
dc.identifier.urihttps://doi.org/10.4274/balkanmedj.galenos.2020.2020.1.140
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8634
dc.identifier.volume37
dc.identifier.wosWOS:000582143700003
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorGünaydın, Nurşen Ciğerci
dc.language.isoen
dc.publisherGalenos Publ House
dc.relation.ispartofBalkan Medical Journal
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectChildren
dc.subjectcow's milk allergy
dc.subjectoral immunotherapy
dc.subjectQuality-Of-Life
dc.subjectFood Allergy
dc.subjectTolerance Induction
dc.subjectChildren
dc.subjectIge
dc.subjectEfficacy
dc.subjectDesensitization
dc.subjectQuestionnaire
dc.subjectPredictors
dc.subjectProtocol
dc.titleOral Immunotherapy for Cow's Milk Allergy: Five Years' Experience from a Single Center in Turkey
dc.title.alternativeOral Immunotherapy for Cow's Milk Allergy: Five Years' Experience from a Single Center in Turkey
dc.typeArticle

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