IgE-Mediated Cow's Milk Allergy: Skin Prick Test Subtypes and Clinical Phenotypes Using Cow's Milk Hydrolysate Infant Formulas

Abstract

In 1986, Hill (Australia) classified group 1 children with cow's milk allergy (CMA) as having rapid onset, IgE-mediated reactions. In 1989, Schwartz (Rochester, NY) subtyped group 1 children (n = 75) into 1A, 1B, and 1C based on skin prick tests (SPTs) to non-hydrolyzed (CM—Similac®) and hydrolyzed CM infant formulas (Good Start®—partially hydrolyzed; Nutramigen®—extensively hydrolyzed). Our objective was to test the hypothesis that SPT subtypes 1A, 1B, and 1C represent different clinical phenotypes. Children with group 1 CMA (n = 170) were evaluated between 1989 and 2000. Clinical data analyzed included SPT subtype, signs, and symptoms after CM ingestion, age of onset, presence of other atopic conditions, serum CM-specific IgE, total serum IgE, and follow-up SPTs. Compared to 1A (n = 82), 1B (n = 58), and 1C (n = 30) had higher rates (p < 0.001) of systemic reactions to CM, higher (p < 0.001) serum-specific IgEs to CM proteins (α-lactalbumin, β-lactoglobulin, casein), higher prevalences of recurrent whee...