Types of Cow Milk Allergy (CMA)

 

Cow milk allergy may be:

(1) IgE-mediated

(2) non-IgE-mediated: food protein-induced enterocolitis syndrome (FPIES) associated with cow milk protein (FMP)

(3) mixed

 

Clinical findings associated with IgE-mediated CMA:

(1) onset within 2 hours of drinking cow milk

(2) skin rash

(3) urticaria

(4) respiratory symptoms (cough, wheeze)

(5) vomiting

(6) variable hypotension

(7) positive RAST test

 

Clinical findings associated with CMP FPIES:

(1) onset several hours after drinking cow milk

(2) recurrent vomiting with nausea

(3) lethargy

(4) diarrhea with or without bleeding

(5) abdominal pain

 

The diagnosis is supported if

(1) symptoms disappear after milk is withdrawn from the diet.

(2) an oral food challenge (OFC) results in relapse (if safe to be perform)