DELAYED-TYPE HYPERSENSITIVITY TO COWS MILK PROTEIN IN MELKERSSON-ROSENTHAL SYNDROME - COINCIDENCE OR PATHOGENETIC ROLE

Background: Intolerance to cow's milk protein is frequently seen in ch ildren and rarely in adults. Non-IgE-mediated hypersensitivity to cow' s milk protein has been suspected in children based on in vitro eviden ce. Food intolerance may play a pathogenetic role in some cases of Mel kersson-Rosenthal syndrome, which is often of unknown origin. Objectiv e: We describe an adult female patient who developed a Melkersson-Rose nthal syndrome and at the same time was found to have in vivo and in v itro evidence of a delayed-type hypersensitivity to cow's milk protein . Methods: Allergic and immunologic examinations, including skin prick tests, patch tests, serology, lymphocyte transformation tests and bio psies were performed. Results: A positive patch test to alpha-lactalbu min, a positive lymphocyte transformation test to whole cow's milk and an immunohistology with infiltration of CD4+ and CD8+ T cells were fo und. Conclusions: There is a possible pathogenetic relation between de layed-type hypersensitivity to cow's milk protein and Melkersson-Rosen thal syndrome in the patient presented.