Immunology

Question 1

Who gets Cow’s Milk Protein Allergy?

Answer 1

infants and young children under age 3
formula feeding
personal or FHx of atopy

Question 2

2 types of Cow’s Milk Protein Allergy?

Answer 2

IgE mediated -> within hours of ingestion
non-IgE mediated -> over several days

Question 3

Presentation of CMPA?

Answer 3

usually before 1yr of age
bloating and wind
abdo pain
diarrhoea
vomiting
urticarial rash
angio-oedema
cough/wheeze
sneezing
watery eyes
eczema

anaphylaxis in rare cases

Question 4

Diagnosis of CMPA?

Answer 4

Hx and exam
skin prick testing can confirm but not always necessary

Question 5

Mx of CMPA?

Answer 5

avoiding cow’s milk

breastfeeding mothers should avoid dairy
hydrolysed formulas
elemental formulas (amino acids) in severe cases

most children outgrow CMPA by 3
can be trialled on the milk ladder

Question 6

CMPA vs cow’s milk protein intolerance?

Answer 6

intolerance = GI symptoms but not the allergy symptoms