Yitzhak Katz, MD, Nelly Rajuan, MSc, Michael R

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Presentation transcript:

Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy Yitzhak Katz, MD, Nelly Rajuan, MSc, Michael R. Goldberg, MD, PhD, Eli Eisenberg, PhD, Eli Heyman, MD, Adi Cohen, MD, Moshe Leshno, MD, PhD Journal of Allergy and Clinical Immunology Volume 126, Issue 1, Pages 77-82.e1 (July 2010) DOI: 10.1016/j.jaci.2010.04.020 Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Cohort description. All 381 parents of infants in whom an adverse reaction to CMP was suspected were interviewed by one of the investigators (N.R.), and their infants were invited for an examination. Additional contacts were made as appropriate in these patients, and at the final contact at the ages of 3 to 5 years, 21 infants were lost to follow-up. Journal of Allergy and Clinical Immunology 2010 126, 77-82.e1DOI: (10.1016/j.jaci.2010.04.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Number of patients with IgE-CMA according to their age of onset (in days). The 8 patients with onset of IgE-CMA at an age of 240 days or greater were initially given diagnoses of FPIES. Journal of Allergy and Clinical Immunology 2010 126, 77-82.e1DOI: (10.1016/j.jaci.2010.04.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 IgE-CMA occurrence as a function of the age of CMP introduction. The different groups are defined as follows: group I (green), age of CMP exposure of 0 to 14 days; group II (II+II∗) (yellow), age of CMP exposure of 15 to 104 days; group III (red), age of CMP exposure of 105 to 194 days; and group IV (yellow), age of CMP exposure of 195 to 374 days. For statistical analysis, the second and third bins were combined into one group (group II, group II∗). The error bar represents the statistical error caused by the finite group size (1 SD). A fraction of infants with IgE-CMA are significantly (P < .001) different for all pairwise comparisons among the 4 groups, except for group II versus group IV. Journal of Allergy and Clinical Immunology 2010 126, 77-82.e1DOI: (10.1016/j.jaci.2010.04.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Systems affected in patients during IgE-mediated reactions Systems affected in patients during IgE-mediated reactions. C, Cutaneous reaction (urticaria, angioedema, and pruritus); GI, gastrointestinal reactions (vomiting and diarrhea); R, respiratory system (sneezing, shortness of breath, coughing, and choking); S, systemic reaction (shock, crying, fainting, and restlessness). Although we rated pruritis, crying, restlessness, and choking, more objective findings, such as urticaria, vomiting, shortness of breath, and anaphylaxis, were used to establish the diagnosis. Journal of Allergy and Clinical Immunology 2010 126, 77-82.e1DOI: (10.1016/j.jaci.2010.04.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions