Abstract
Background: Cow milk allergy (CMA) is the clinical presentation of cow milk protein (CMP) sensitization. CMA is a prevalent morbidity worldwide especially in children.
Objective: To identify common allergic diseases associated with CMP sensitization.
Methods: This was a retrospective chart review conducted. Data from 83 patients were included in the study. Patients included in this study were those diagnosed with CMA at the allergy clinics of Laluna, a private medical center in Jeddah, Saudi Arabia. All in vitro tests of 83 CMA cases were performed retrospectively in 2018 utilizing a RIDA (R) system panel, which contains 30 common food sensitizers unique to Saudi Arabia. CMPs and other food sensitizations were determined based on the clinical allergic disease diagnoses taken from a local database in Laluna clinic.
Results: SIgE food allergy tests for 83 patients were evaluated. Gender distribution was 51 females (61.5%) and 32 males (38.5%). The most common CMP sensitizations, order were alpha lactalbumin, 59 (71%); casein, 48 (58%); milk, 38 (46%); beta lactoglobulin, 29 (35%); and assorted cheeses mix 13 (16%). Allergic diseases associated with CMP sensitization were atopic dermatitis, 40 (48%); allergic rhinosinusitis, 36 (43%); asthma, 26 (31%); allergic conjunctivitis, 12 (14%); urticaria and angioedema, 10 (12%). As for the most common associated food sensitizers, in the category of nuts, cashews and peanuts caused the most severe reaction. In the category of grains, wheat was also implicated in severe reactions, and egg in the protein category. The severity of CMP sensitizations are as follows, in descending order: alpha lactalbumin (94.3); casein (58.54); milk (51.19); beta lactoglobulin (29.11) and assorted cheeses mix.
Conclusion: Alpha lactalbumin and casein, followed by milk are the most common sensitizers and also cause the most severe allergic reactions. Atopic dermatitis and allergic rhinosinusitis, followed by asthma are the most common clinical allergic diseases associated with CMP sensitization. Cashew, peanut, wheat and egg were the most common food sensitizers associated with CMP sensitization. It should be noted that the most severe food sensitizer of all associated with CMP sensitization is cashew.