Risk factors for severe reactions in a low-dose oral food challenge in cow’s milk

Abstract

 Background : The oral food challenge (OFC) can induce the life-threatening anaphylaxis. We should predict a high risk patient for developing severe reactions. Objectives : To identify the risk factors for severe reactions in a low-dose OFC in cow’s milk. Methods : We studied milk allergy patients who underwent a low-dose (less than 5 ml) OFC with cow’s milk from 2011 to 2016. The moderate and severe group was defined as Grade≧2, while the negative and mild group was defined as Grade≦1 according to the classification of the anaphylaxis guideline. We collected the clinical variables (age, cumulative elicit dose, history of bronchial asthma and atopic dermatitis, sensitization for multi allergen, a history of anaphylaxis in cow’s milk and symptoms other than skin, family history of bronchial asthma and period from the onset of anaphylaxis to the OFC) and laboratory data (milk-specific IgE and total IgE) of the patients from their medical records and compared them between two groups. Results : A history of anaphylaxis in cow’s milk, history of bronchial asthma and family history of bronchial asthma were risk factors for inclusion in the moderate and severe group. Conclusion : We should pay attention to the infants with a history of anaphylaxis in cow’s milk, history of bronchial asthma or family history of bronchial asthma before performing a low-dose OFC in cow’s milk.