Beef and cow's milk: the same precaution. Two cases of possible sensitization to bovine serum albumin

The authors report two observations of possible sensitization to bovine ser um albumin, involving two children of 5 and 4 years of age. For the 5-year- old child, the sensitization is associated to the inability to tolerate cow 's milk (eyelid edema, abdominal pains), and for the 4-year-old child, to t he inability to tolerate undercooked beef (extensive urticaria and face ede ma). The biological profiles of the children are alike. both characterized by the presence of IgE specific for whole cow's milk, beef and bovine serum albumin. There is no IgE specific for the usual cow's milk proteins, alpha -lactalbumin, beta-lactoglobulin and casein. For the two boys, the prick-te sts have been negative concerning milk and its components. But they have be en positive concerning meat only for the child allergic to it. It is difficult to explain the clinical difference between the two children considering their probable common serum albumin sensitization. This kind o f sensitization is rare, particularly when if is isolated. In practice, one must make sure that the whole milk-specific IgE test includes, among other s, serum albumin-specific IgE. This sensitization accounts for RAST positiv ities concerning both milk and meat. But the removal of only one of those f oods is justified for both of the children. (C) 2001 Editions scientifiques et medicales Elsevier SAS.