Children with more severe atopic dermatitis less likely to outgrow egg or milk allergy
MONDAY, March 21 (HealthDay News) -- One-third of infants with a history of milk allergy appear to resolve their allergy within 30 months, though children with more severe atopic dermatitis (AD) appear to be less likely to outgrow egg or milk allergy, according to two studies presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from March 18 to 22 in San Francisco.
For both studies, Robert A. Wood, M.D., of Johns Hopkins University in Baltimore, and colleagues evaluated children, aged 3 to 15 months, with either a convincing history of egg and/or milk allergy with a positive prick skin test (PST) to the trigger food, and/or moderate to severe AD and a positive PST to milk or egg. The researchers scored AD severity using the Langeland & Rajka criteria at baseline and at two years, and assessed severity categorically as none to mild (NM-AD) and moderate to severe (MS-AD).
In the first study, the researchers found that, among 244 children with milk allergy at baseline, 89 had resolution of their allergy by month 30 of follow-up, with a Kaplan-Meier probability of milk allergy resolution of 36.9 percent. Factors predicting allergy resolution included lower baseline milk-IgE, smaller baseline milk PST wheal size, and mild to none versus moderate to severe baseline atopic dermatitis. In the second study, the researchers found that 46 percent of those enrolled with NM-AD had resolution of milk allergy, compared with 25 percent of those with MS-AD (P = 0.004). Nineteen percent of those with MS-AD at baseline who improved to NM-AD experienced resolution of milk allergy, compared with 32 percent of those who remained MS-AD (P = 0.11). Thirty-nine percent of the children with NM-AD at enrollment resolved their egg allergy, compared with 21 percent of those enrolled with MS-AD (P = 0.047); 28 percent of those with MS-AD at enrollment who improved to NM-AD over two years and 22 percent of those who remained MS-AD resolved their egg allergy (P = NS).
"These findings will help clinicians caring for infants with eczema and milk or egg allergy and provide more accurate advice to parents about the likely course of their child's milk or egg allergy," Wood said in a statement.
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Abstract No. 126