ALLERGENICITY OF MILK PROTEIN HYDROLYSATE FORMULAS IN CHILDREN WITH COWS MILK ALLERGY

Cow's milk protein hydrolysate formulae have been developed to lower o r eliminate the allergenicity of cow's milk proteins, and to reduce th e antigenic load and the risk of sensitization. Cross-reactivity betwe en different hydrolysate formulae and cow's milk proteins has been dem onstrated. We have studied 20 children (median age 31 months, range 15 -76 months) with a history of IgE-mediated cow's milk allergy. All the children had immediate allergic respiratory and/or cutaneous and/or g astro-intestinal reactions to cow's milk ingestion. In addition, the c hildren had positive prick skin tests and positive RAST to cow's milk. Prick skin test, RAST, and double-blind placebo controlled food chall enges were performed with three different hydrolysate formulae: a case in hydrolysate formula and two whey formulae, one partially and one ex tensively hydrolyzed. All 20 children had immediate allergic reactions after the challenge test with cow's milk. Only 2/20 children had a po sitive challenge test with a casein hydrolysate formula (Alimentum): o ne developed asthma and one urticaria. Two of the 15 children challeng ed with an extensively hydrolysed whey formula (Profylac) developed pe rioral erythema. Nine out of 20 children had a positive challenge test with a partially hydrolysed whey formula (Nidina H.A.): four develope d asthma, three urticaria and two lip oedema. All children had positiv e prick skin tests to cow's milk proteins (casein and/or lactalbumin); 9 to Nidina H.A.; 3 to Profylac, and 3 to Alimentum. Specific IgE ant ibodies to cow's milk were present in all children; in 13 to Nidina H. A., in 4 to Profylac, and in 3 to Alimentum.