| Abstrakt: |
There are several protein HFs which have been defined as “hypoallergenic” and are devised for children with allergy to cows milk (CM) HFs are processed using two main techniques: heat denaturation and enzymatic hydrolysis to reduce the molecular weight (mw) of peptides and their allergenic power. However, cases of anaphylaxis in children with IgE-mediated CMA and fed whey HFs have been reported. We have selected 20 children (15 M, 5 F) aged 5 mo-3 yr (median age 1 yr + 6 mo) with IgE-mediated CMA (positive STs and RAST), 15 of whom had immediate-type (urticaria, angioedema, shock, asthma, vomiting, diarrhea), and 5 delayed-type reactions (atopic dermatitis). Diagnosis was done on the basis of anamnesis, elimination-provocation (open) tests under medical surveillance, positive STs, and specific IgE to CM proteins, IgE to HFs were measured using an immunoenzymatic technique (Phadezym RAST. Pharmacia). IgE to CM were detectable in 19 babies, to a-lactalbumin in 20, to ß-lactoglobulin in 19, to casein in 16, to a partially HF (Nidina HA) in 7, and to an extensively HF (Prophylac) in 4. This data demonstrates that a cross-reactivity between CM proteins and the epitopes present in HFs is a distinct possibility. In conclusion, the peptides of HFs still have allergenic potency and can be recognized by the cell-bound IgE of a child allergic to CM. Therefore the use of whey HFs should be avoided in children with IgE-mediated CMA |
