Author:
El-Hodhod Moustafa A.,El-Shabrawi Mortada H. F.,AlBadi Ahmed,Hussein Ahmed,Almehaidib Ali,Nasrallah Basil,AlBassam Ebtsam Mohammed,El Feghali Hala,Isa Hasan M.,Al Saraf Khaled,Sokhn Maroun,Adeli Mehdi,Al-Sawi Najwa Mohammed Mousa,Hage Pierre,Al-Hammadi Suleiman
Abstract
Abstract
Background
This study aimed to develop an expert consensus regarding the epidemiology, diagnosis, and management of cow’s milk protein allergy (CMPA) in the Middle East.
Methods
A three-step modified Delphi method was utilized to develop the consensus. Fifteen specialized pediatricians participated in the development of this consensus. Each statement was considered a consensus if it achieved an agreement level of ≥ 80%.
Results
The experts agreed that the double-blind placebo-controlled oral challenge test (OCT) should be performed for 2–4 weeks using an amino acid formula (AAF) in formula-fed infants or children with suspected CMPA. Formula-fed infants with confirmed CMPA should be offered a therapeutic formula. The panel stated that an extensively hydrolyzed formula (eHF) is indicated in the absence of red flag signs. At the same time, the AAF is offered for infants with red flag signs, such as severe anaphylactic reactions. The panel agreed that infants on an eHF with resolved symptoms within 2–4 weeks should continue the eHF with particular attention to the growth and nutritional status. On the other hand, an AAF should be considered for infants with persistent symptoms; the AAF should be continued if the symptoms resolve within 2–4 weeks, with particular attention to the growth and nutritional status. In cases with no symptomatic improvements after the introduction of an AAF, other measures should be followed. The panel developed a management algorithm, which achieved an agreement level of 90.9%.
Conclusion
This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
Reference100 articles.
1. Fiocchi A, Schünemann HJ, Brozek J, Restani P, Beyer K, Troncone R, et al. Diagnosis and rationale for action against cow’s milk allergy (DRACMA): a summary report. J Allergy Clin Immunol. 2010;126:1119–28.
2. Mousan G, Kamat D. Cow’s milk protein allergy. Clin Pediatr (Phila). 2016;55:1054–63.
3. Maksoud HMA, Al-Seheimy LA, Hassan KA, Salem M, Elmahdy EA. Frequency of cow milk protein allergy in children during the first 2 years of life in Damietta Governorate. Al-Azhar Assiut Med J Medknow. 2019;17:86.
4. Hill DJ, Hosking CS. Food allergy and atopic dermatitis in infancy: an epidemiologic study. Pediatr Allergy Immunol. 2004;15:421–7.
5. Hill DJ, Hosking CS, De Benedictis FM, Oranje AP, Diepgen TL, Bauchau V, et al. Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy: an international study. Clin Exp Allergy. 2008;38:161–8.
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献