Methods: Case series with 30 children (> 4 years) and adolescents with anaphylaxis to CM.
Results: The mean age was 8.9 years (min:4-max:20),14 female. The first symptoms occurred before the 1st year of age in 96.6% being 43.3% before 6 months.The most frequent manifestation after the 1st exposure was urticarial (63.3%), while anaphylaxis occurred in 26.7%. About 1/3 of patients reacted with minute amounts of CM, being 47% in raw form. In 86.7% symptoms appeared in less than 1 hour.About 65% had presented from 1 to 5 episodes of anaphylaxis before starting treatment. The mean of Specific IgE levels (sIgE) for CM was 57.05 KU/L and median 54.5 (Min:9.0 KU/l - Max:> 100 KU/L); for casein the mean was 48.5 KU/L and the median 30.1 KU/L (7.0 to > 100). For α lacto-albumin and β-lactoglobulin, these results were respectively 27.10 KU/L (1.0 KU/l to> 100 KU / L) and 16.48 KU/L (2.3 KU/ L to 86.7 KU/L).
Conclusions: Severe forms of CMA are initiated early and can persist through adolescence. The most frequent initial symptom was urticaria, which appeared in less than 1 hour after intake of small amounts of milk. In these patients the levels of sIgE to CMP are very high, especially casein.