Allergy to protein in cow's milk can lead to food intolerance in infants. A score developed by Verwimp et al in the Netherlands can help evaluate an infant for the types of symptoms present and to monitor response to changes in diet.
Symptom subscores:
(1) skin
(2) respiratory tract
(3) gastrointestinal tract
(4) general
Parameters for Skin Subscore |
Finding |
Points |
---|---|---|
itchy eczema |
absent |
5 |
|
present |
1 |
urticaria |
absent |
0 |
|
present |
1 |
edema |
absent |
0 |
|
present |
1 |
conjunctivitis |
absent |
0 |
|
present |
1 |
skin subscore =
= SUM(points for all 4 parameters)
Parameters for Respiratory Subscore |
Finding |
Points |
---|---|---|
tightness |
absent |
0 |
|
present |
1 |
rhinitis |
absent |
0 |
|
present |
1 |
cough |
absent |
0 |
|
present |
1 |
wheeze |
absent |
0 |
|
present |
1 |
dyspnea |
absent |
0 |
|
present |
1 |
respiratory subscore =
= SUM(points for all 5 parameters)
Parameters for GI Symptoms |
Finding |
Points |
---|---|---|
vomiting |
absent |
0 |
|
present |
1 |
colic |
absent |
0 |
|
present |
1 |
diarrhea |
absent |
0 |
|
present |
1 |
gastrointestinal subscore =
= SUM(points for all 3 parameters)
Parameters for General Symptoms |
Finding |
Points |
---|---|---|
inconsolable cry |
absent |
0 |
|
present |
1 |
refusing food |
absent |
0 |
|
present |
1 |
general symptoms subscore =
= SUM(points for both parameters)
cow's milk protein intolerance score =
= SUM(all 4 subscores)
Interpretation:
• minimum subscore and total score: 0
• maximum skin subscore: 8
• maximum respiratory tract subscore: 5
• maximum gastrointestinal tract subscore: 3
• maximum general subscore: 2
• maximum total score: 18
Purpose: To evaluate an infant for symptoms of intolerance to cow's milk protein.
Specialty: Immunology/Rheumatology, Nutrition, Pedatrics
Objective: clinical diagnosis, including family history for genetics, severity, prognosis, stage
ICD-10: Z88,