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Real-Life Follow-up in Cows Milk Immunotherapy: Clinical and Serological Data
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Paloma Poza-Guedes, MD, Ruperto González-Pérez, MD, PhD, Inmaculada Sanchez-Machin, MD, Victor Matheu, MD, PhD
Rationale: Although oral milk inmunotherapy (OMI) is becomig widely extended as a promising therapy in patients with persistent cow’s milk allergy (CMA), there is relative scarce experience in real-life clinical practice. 

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.