Rahaf Hasanein Cows Milk Protein Allergy is an immune system response to one or both of the proteins Casein amp Whey Cows Milk Protein Allergy or CMPA is the most common infant food ID: 908527
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Slide1
Cow's milk protein allergy
Rahaf
Hasanein
Slide2Cow's Milk Protein Allergy is an immune system response to one or both of the proteins, Casein & Whey.
Cow's
Milk Protein Allergy (or CMPA) is the most common infant food
allergy affecting 1.9% - 4.9% of infants worldwide.
Tolerance in 50% of children by the age of 1 year, and in 80-90% by the age of 5 years.
Slide3Types
1) The immunoglobulin E (
IgE
)-mediated type (Immediate reaction)
Less than 2 Hours
Urticaria/hives
Wheezing
Rhinitis
Itching or a tingling feeling around the mouth or lips
Angioedema: swelling of the lips, tongue or throat
Coughing or shortness of breath
Vomiting
Anaphylaxis
Slide4Slide52) Non-
IgE
-mediated (Late reaction)
>= 2 Hours
Atopic dermatitis
Diarrhea
Hematochezia
Abdominal cramps
Colic
Vomiting, GERDFood refusal
Slide6Food-protein induced enterocolitis syndrome(FPIES)
severe vomiting and diarrhea within 2-4 hours after ingestion of milk causing profound dehydration, lethargy, and sometimes shock
Chronic exposure my present with regurgitation, diarrhea, failure to thrive, and hypoalbuminemia
Slide7Food protein-induced
proctitis
/proctocolitis
bloody-streaked,
mucousy
, loose stools and occasionally diarrhea
Slide8Food protein-induced enteropathy
Protracted diarrhea in the first nine months of life, within weeks after introduction of milk. The majority of affected infants have failure to thrive, and some present with malabsorption.
Slide9Heiner syndrome (food-induced pulmonary hemosiderosis)
Cough, recurrent fever, wheezing, nasal congestion, recurrent otitis media, hemoptysis, failure to thrive, dyspnea, colic, anorexia, vomiting, diarrhea and hematochezia
Slide10Diagnosis
1- Histoy and physical exam.
2- Diagnostic elemination and open challenge test.
3- other tests.
Slide11Slide12Slide13Physical exam
Wt
and Ht.
General exam/appearance.
Signs of anemia.
Respiratory and gastrointestinal exam.
Blood in stool?
Skin
Slide14CMPA
Lactose intelorance
Slide15Slide16If the infant is suspected of having
IgE
mediated CMPA, then a specific
blood
IgE
level
or
skin prick test
in a clinical setting is often used to aid diagnosis.
In severe IgE-mediated CMPA Usually CMP is eliminated from the diet for 12-18 months and then the patient is rechallenged in a clinical setting. If the patient still has reactivity, the elimination diet is continued for another
6-12 months
and the patient again is rechallenged.
Slide17Other tests?
Occult blood.
CBC.
Sigmoidoscopy if bleeding continued for more than 12 weeks after elimination.
Slide18When re-challenge test is not done?
Hx of anaphylactic shock.
Slide19Thank you