Milk components: Improved risk assessment when testing with allergen components
Alice, a 7-year-old who has experienced gastrointestinal distress, vomiting, and urticaria after consuming products with milk, visits her healthcare provider for testing.
The healthcare provider conducts a full clinical history and physical examination and decides to test using whole milk with reflex to components.
Specific IgE blood testing can help determine how likely Alice is to tolerate milk.
Patient History
Family History
- None
Alice’ Personal History
- Alice experienced gastrointestinal distress, vomiting, and hives after consuming milk and products made with milk when she was 8 months old .
- Her parents promptly removed milk and milk products from her diet and switched her to soy milk.
Alice’s ImmunoCAPTM Test Results
These results together with this patient's case history and symptoms, help confirm the diagnosis.
Test |
Type |
Alice’s Results |
Milk |
Whole Allergen |
12 kU/L |
Bos d 4 (α-lactalbumin) |
Allergen Component |
1.22 |
Bos d 5 (β-lactoglobulin) |
Allergenr Component |
<0.10 |
Bos d 8 (casein) |
Allergen Component |
7.53 |
Differential Diagnosis
Alice’s sensitization to α-lactalbumin and significant levels of IgE to casein indicates a risk for reaction to all forms of milk. 1
REFINED DIAGNOSIS
- Milk allergy
HEALTHCARE PROVIDER MANAGEMENT PLAN
- Alice's healthcare provider advises her and her parents that Alice is unlikely to become tolerant to cow’s milk over time.
- Her healthcare provider advises her to continue to avoid all foods with milk and baked milk products, as well as avoid products processed with milk.
- Alice’s dietary restriction to all forms of milk remains.
- Alice is unlikely to outgrow her milk allergy—however, regular follow up is important.
FOLLOW UP
- Alice with her parents are seen by her healthcare provider one year later. Alice has continued to keep milk out of her diet and is doing well.
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- Tosca MA, Pistorio A, Rossi GA, Ciprandi G. Cow’s Milk Allergy: the Relevance of IgE. Allergy, Asthma & Immunology Research. 2016;8(1):86-87. doi:10.4168/aair.2016.8.1.86.
