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首页> 外文期刊>Clinical and experimental allergy : >Home‐based cow's milk reintroduction using a milk ladder in children less than 3?years old with IgE‐mediated cow's milk allergy
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Home‐based cow's milk reintroduction using a milk ladder in children less than 3?years old with IgE‐mediated cow's milk allergy

机译：家庭牛奶重新引入使用牛奶梯在儿童少于3岁？岁月与IgE介导的牛奶过敏

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Summary Background The development of tolerance to cow's milk in allergic children is best determined by supervised baked milk exposure. Widely recommended hospital‐based challenges can potentially delay contact because of resource limitations. Objective We sought to determine the efficacy and safety of our low‐dose home‐based reintroduction programme. Methods In our allergy service, children with IgE‐mediated cow's milk allergy who met set criteria (presenting with skin and/or gastrointestinal symptoms only and skin prick test??8?mm) are considered for home‐based milk reintroduction (HMR). Early contact is low‐dose ingestion of a commercial baked milk biscuit with slow gradual further exposure followed by increasing milk contact using a milk ladder. We retrospectively reviewed 4‐6 monthly attendance records assessing allergic symptoms, evolving milk tolerance, and compliance. Tolerance was determined using a 7 scale scoring system based on the milk ladder. Results The clinic attendance and dietetic contact records of 86 children (49 girls) who underwent HMR were reviewed. HMR was started at a median of 13?months with 49% 8‐12?months, 40% 13‐18?months and 11% 19‐33?months. Allergic symptoms were reported in 81 (43%) of 189 dietetic reviews, 65 (80%) of which were from the milk ladder; no patient experienced anaphylaxis requiring treatment with intramuscular adrenaline. After four reviews, only eight patients were not tolerating almost all dairy products, and there was a high rate of completion with only a further seven patients lost to the programme. Conclusion and Clinical Relevance Cow's milk can be successfully and safely reintroduced in a cautious low‐dose exclusively home‐based programme in the appropriate clinical and family setting.
机译：发明内容背景通过监督烘焙牛奶暴露最依赖于过敏性儿童对过敏性儿童牛奶的耐受性的发展。由于资源限制，广泛推荐的基于医院的挑战可能会延迟接触。目的我们寻求确定我们基于低剂量的家庭重新引入程序的疗效和安全性。方法在我们的过敏服务中，患有IgE介导的牛奶过敏的儿童遇到了设定标准（仅用皮肤和/或胃肠症状而呈现皮肤刺鼠和皮肤刺测试？＆？8？mm）被认为是家庭的牛奶重新引入（HMR ）。早期接触是低剂量摄入商业烘焙牛奶饼干，缓慢逐渐进一步曝光，然后使用牛奶梯增加牛奶接触。我们回顾性地审查了4-6条每月出席记录评估过敏症状，不断发展的牛奶耐受性和遵守性。使用基于牛奶梯的7个规模评分系统确定耐受性。结果审查了86名儿童（49名女孩）的临床考勤和饮食接触记录。 HMR开始于13个月的中位数，49％8-12？几个月，40％13-18？月份和11％19-33个月。 81例（43％）的189名饮食评论，65（80％）的过敏症状均来自牛奶梯;没有患者经历过视性，需要用肌内肾上腺素治疗。在四次评论后，只有8名患者不容忍几乎所有的乳制品，并且只有较高的完成率，只有另外7名患者损失了该计划。结论和临床相关性牛奶可以在适当的临床和家庭环境中成功和安全地在谨慎的低剂量中进行谨慎低剂量的核心计划重新介绍。

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