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Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure

BACKGROUND: Oral immunotherapy (OIT) is a promising therapeutic approach for children with persistent IgE‐mediated cow's milk allergy (CMA) but data are still limited. OBJECTIVE: To analyze the prevalence of life‐threatening anaphylaxis in children with persistent CMA undergoing OIT and to eval...

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Autores principales: Badina, Laura, Burlo, Francesca, Belluzzi, Beatrice, Babich, Sara, Berti, Irene, Barbi, Egidio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8962636/
https://www.ncbi.nlm.nih.gov/pubmed/35349753
http://dx.doi.org/10.1002/iid3.607
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author Badina, Laura
Burlo, Francesca
Belluzzi, Beatrice
Babich, Sara
Berti, Irene
Barbi, Egidio
author_facet Badina, Laura
Burlo, Francesca
Belluzzi, Beatrice
Babich, Sara
Berti, Irene
Barbi, Egidio
author_sort Badina, Laura
collection PubMed
description BACKGROUND: Oral immunotherapy (OIT) is a promising therapeutic approach for children with persistent IgE‐mediated cow's milk allergy (CMA) but data are still limited. OBJECTIVE: To analyze the prevalence of life‐threatening anaphylaxis in children with persistent CMA undergoing OIT and to evaluate potential risk factors. METHODS: This is a retrospective cohort study among children with persistent CMA undergoing OIT over a 20‐year period, following a specific Oral Tolerance Induction protocol. Adverse reactions during the whole period and data on long‐term outcome were registered. Descriptive and nondescriptive statistics were used to describe data. RESULTS: Three hundred forty‐two children were evaluated. During OIT, 12 children (3.5%) presented severe anaphylactic reactions that needed an adrenaline injection. None required intubation, intensive care unit (ICU) admission, or showed a fatal outcome. Five of them abandoned OIT, five reached unrestricted diet and the others are still undergoing OIT. As far as outcome is concerned, 51.2% reached an unrestricted diet; 13.5% are at the build‐up stage; and 28.0% (97 patients) stopped the OIT. Among these 96 children, 6.3% experienced a severe reaction induced by accidental ingestion of milk with two fatal outcomes. CONCLUSIONS: The risk of life‐threatening reactions was nearly two times lower (3.5% vs. 6.3%) among patients assuming milk during OIT than in those who stopped the protocol. A trend in favor of more severe reactions, requiring ICU admission, or fatal, was shown in patients who stopped OIT.
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spelling pubmed-89626362022-04-04 Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure Badina, Laura Burlo, Francesca Belluzzi, Beatrice Babich, Sara Berti, Irene Barbi, Egidio Immun Inflamm Dis Original Articles BACKGROUND: Oral immunotherapy (OIT) is a promising therapeutic approach for children with persistent IgE‐mediated cow's milk allergy (CMA) but data are still limited. OBJECTIVE: To analyze the prevalence of life‐threatening anaphylaxis in children with persistent CMA undergoing OIT and to evaluate potential risk factors. METHODS: This is a retrospective cohort study among children with persistent CMA undergoing OIT over a 20‐year period, following a specific Oral Tolerance Induction protocol. Adverse reactions during the whole period and data on long‐term outcome were registered. Descriptive and nondescriptive statistics were used to describe data. RESULTS: Three hundred forty‐two children were evaluated. During OIT, 12 children (3.5%) presented severe anaphylactic reactions that needed an adrenaline injection. None required intubation, intensive care unit (ICU) admission, or showed a fatal outcome. Five of them abandoned OIT, five reached unrestricted diet and the others are still undergoing OIT. As far as outcome is concerned, 51.2% reached an unrestricted diet; 13.5% are at the build‐up stage; and 28.0% (97 patients) stopped the OIT. Among these 96 children, 6.3% experienced a severe reaction induced by accidental ingestion of milk with two fatal outcomes. CONCLUSIONS: The risk of life‐threatening reactions was nearly two times lower (3.5% vs. 6.3%) among patients assuming milk during OIT than in those who stopped the protocol. A trend in favor of more severe reactions, requiring ICU admission, or fatal, was shown in patients who stopped OIT. John Wiley and Sons Inc. 2022-03-29 /pmc/articles/PMC8962636/ /pubmed/35349753 http://dx.doi.org/10.1002/iid3.607 Text en © 2022 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Badina, Laura
Burlo, Francesca
Belluzzi, Beatrice
Babich, Sara
Berti, Irene
Barbi, Egidio
Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
title Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
title_full Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
title_fullStr Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
title_full_unstemmed Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
title_short Life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
title_sort life‐threatening anaphylaxis in children with cow's milk allergy during oral immunotherapy and after treatment failure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8962636/
https://www.ncbi.nlm.nih.gov/pubmed/35349753
http://dx.doi.org/10.1002/iid3.607
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