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Clinical features of cow's milk protein allergy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Clinical Features of IgE mediated cow's milk protein allergy

Possible dermatological features include:

  • pruritus
  • erythema
  • acute urticaria (localised or generalised)
  • acute angioedema (most commonly in the lips and face, and around the eyes

Possible gastroenterological features include:

  • agioedema of the lips, tongue, and palate
  • oral pruritus
  • colicky abdominal pain
  • nausea
  • vomiting
  • diarrhoea

Respiratory system (usually in combination with one or more of the above symptoms and signs)

  • upper respiratory tract symptoms (nasal itching, sneezing, rhinorrhoea, or congestion, with or without conjunctivitis)
  • lower respiratory tract symptoms (cough, chest tightness, wheezing, or shortness of breath)

Other

  • signs or symptoms of anaphylaxis or other systemic allergic reactions

Clinical Features of non-IgE mediated cow's milk protein allergy

Possible dermatological features include:

  • pruritus
  • erythema
  • atopic eczema

Possible gastroenterological features include:

  • gastro-oesophageal reflux disease
  • loose or frequent stools
  • bood and /or mucus in the stools
  • abdominal pain
  • infantile colic
  • constipation
  • perianal redness
  • pallor and tiredness
  • food refusal or aversion
  • faltering growth plus one or more gastrointestinal symptoms above (with or without significant atopic eczema)

Reference:

  • NICE. Food allergy in children and young people: diagnosis and assessment of food allergy in children and young people in primary care and community settings. CG 116. 2011
  • Walsh J et al. Differentiating milk allergy (IgE and non-IgE mediated) from lactose intolerance: understanding the underlying mechanisms and presentations. Br J Gen Pract 2016; DOI: 10.3399/bjgp16X686521

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