Methods: We selected patients with persistent CMA and uncontrolled symptoms despite a strict restrictive diet. We performed a 2-step OMI protocol: first phase (desensitization) in the Allergy clinic, a weekly scheduled protocol individualy adjusted according to clinical tolerance, from diluted milk (1:10) to reach the final dose (250 ml undiluted milk). A second phase of ambulatory clinical follow-up were performed every 6 months during 5 years. Clinical and serological data (specific-IgE and IgG4) were collected after every visit.
Results: Thirty two children (2-17 y.o.) fully completed OMI reaching the final dose. All patients performed the total clinical follow-up during 5 years, although significative adverse reactions were recorded only in the first 2 years. Relevant serological changes were obtained both at the initial phase (first year) and the long-term evolution. All patients were able to have a free cow´s milk diet, and only 3 subjects had persistent goat´s milk allergy.
Conclusions: OMI requires a highly skilled staff but offers encouraging results in the long-term follow-up. Milk allergic patients may benefit from food immunotherapy but an accurate and individual diagnosis is mandatory. OMI protocols must be a custom-designed procedures to reach the desired outcomes.