| The natural history of milk allergy in an observational cohort. | |
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MedLine Citation:
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PMID: 23273958 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: There are few studies on the natural history of milk allergy. Most are single-site and not longitudinal, and these have not identified a means for early prediction of outcomes. METHODS: Children aged 3 to 15 months were enrolled in an observational study with either (1) a convincing history of egg allergy, milk allergy, or both with a positive skin prick test (SPT) response to the trigger food and/or (2) moderate-to-severe atopic dermatitis (AD) and a positive SPT response to milk or egg. Children enrolled with a clinical history of milk allergy were followed longitudinally, and resolution was established by means of successful ingestion. RESULTS: The cohort consists of 293 children, of whom 244 were given a diagnosis of milk allergy at baseline. Milk allergy has resolved in 154 (52.6%) subjects at a median age of 63 months and a median age at last follow-up of 66 months. Baseline characteristics that were most predictive of resolution included milk-specific IgE level, milk SPT wheal size, and AD severity (all P < .001). Baseline milk-specific IgG(4) level and milk IgE/IgG(4) ratio were not predictive of resolution and neither was expression of cytokine-inducible SH2-containing protein, forkhead box protein 3, GATA3, IL-10, IL-4, IFN-γ, or T-bet by using real-time PCR in CD25-selected, casein-stimulated mononuclear cells. A calculator to estimate resolution probabilities using baseline milk IgE level, SPT response, and AD severity was devised for use in the clinical setting. CONCLUSIONS: In this cohort of infants with milk allergy, approximately one half had resolved over 66 months of follow-up. Baseline milk-specific IgE level, SPT wheal size, and AD severity were all important predictors of the likelihood of resolution. |
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Authors:
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Robert A Wood; Scott H Sicherer; Brian P Vickery; Stacie M Jones; Andrew H Liu; David M Fleischer; Alice K Henning; Lloyd Mayer; A Wesley Burks; Alexander Grishin; Donald Stablein; Hugh A Sampson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-28 |
Journal Detail:
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Title: The Journal of allergy and clinical immunology Volume: - ISSN: 1097-6825 ISO Abbreviation: J. Allergy Clin. Immunol. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1275002 Medline TA: J Allergy Clin Immunol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: rwood@jhmi.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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