Improving the diagnosis of cow’s milk protein allergy in infants

Abstract

The research objective is to analyze the possibilities of using the rating clinical scale CoMiSS and the determination of endogenous proteins and peptides in coprofiltrates for the improvement of diagnosis of cow's milk protein allergy (CMPA) in infants. Methods. The study included 60 infants of the first year of life with suspected CMPA: 30 infants with CMPA (the 1^st group), and 30 infants with the secondary lactase deficiency (the 2^nd group). The control group included 20 healthy infants. We assessed clinical symptoms using CoMiSS instrument and cutaneous syndrome based on SCORAD index, determined in coprofiltrates endogenous proteins and peptides: ß-defensin 2, zonulin, eosinophilic cationic protein. Results. In the monitoring groups the total number of points on the scale CoMiSS the score was higher than in the control group, but not significantly different between groups. The differences in the severity of symptoms of lactase deficiency were also unreliable and symptoms of skin lesions were more common in the 1st group. The defeat of the respiratory tract is not registered in any of the child with a secondary hypolactasia. An increase in the ß-defensin 2 in coprofiltrates was typical only for children with the CMPA, zonulin content in children of the 1^st was 1.5 higher than that of children in the 2^nd group, and 2.3 times higher than the control parameters. The level of eosinophil cationic protein in patients with the CMPA was 2.9 times higher than that of children in the 2^nd group, and it was 2.7 times higher than in healthy children. Conclusions. The widespread use of SCORAD index and the tool CoMiSS, and the analysis of the content of endogenous proteins and peptides in coprofiltrates can improve the diagnosis of the CPMA in infants by avoiding invasive research methods and provocative diets.