Evaluating the effectiveness of elimination diet in infants with CMP-induced allergic proctocolitis using CoMiSS.

Abstract

Background: There are no data on using the Cow's Milk Protein Related Symptom Score (CoMiSS), a clinical screening tool, to monitor symptom improvement in infants with cow's milk protein allergy (CMPA). This study aimed to evaluate the efficacy of CoMiSS on elimination diet response in infants diagnosed with Cow's Milk Protein Associated Proctocolitis (CMPAP) compared with healthy controls METHODS: A case-control study with follow-up compared infants with CMPAP on an elimination diet to healthy peers. Infants with CMPAP (n = 13) and healthy infants (n = 22), aged 17-26 weeks, were included. Four visits were conducted at six, seven, nine, and 12 months of age. CoMiSS was assessed at each visit.

Results: CoMiSS significantly decreased after the four-week elimination diet (p < 0.05). At study's end, total CoMiSS scores increased in both groups (p < 0.05). The crying score's median was higher in CMPAP infants than controls at Visits 1 and 3 (p < 0.05). No significant changes were found for other symptoms.

Conclusions: CoMiSS tends to decrease during elimination diet in infants with CMPAP, which is promising for its use in evaluating dietary response. Monitoring the crying score and developing the defecation score specific to CMPAP would serve this purpose more.

Impact: The CoMiSS can be a promising tool for monitoring responses to elimination diets in infants with proctocolitis, a specific subgroup of CMPA. It highlights the potential of CoMiSS to monitor dietary response and suggests refinements for its application, such as focusing on crying scores and developing a CMPA-specific defecation score. The findings pave the way for a novel use of CoMiSS beyond its screening purpose, potentially enhancing clinical management of CMPA in infants with proctocolitis. This approach could lead to more tailored and effective dietary interventions, improving patient outcomes and contributing to the refinement of CMPA management tools.