Diagnosis and management of non-IgE-mediated cow’s milk allergy in infancy - a UK primary care practical guide

Clinical and Translational Allergy

Adam T Fox¹  Joanne Walsh²  Neil Shah³  Trevor Brown⁴  Carina Venter⁵ 

[1] Department of Paediatric Allergy, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, UK;Castle Partnership, Gurney Surgery, Norwich, UK;KU Leuven, Translational Research Centre for Gastrointestinal Disease (TARGID), Leuven, Belgium;The Children’s Allergy Service, The Ulster Hospital, Ulster, Northern Ireland, UK;School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK

关键词: Hypoallergenic formula;    Management;    Diagnosis;    Food allergy;    Primary care;    Cow’s milk allergy;   

Others  :  794277
DOI  :  10.1186/2045-7022-3-23

 received in 2013-04-11, accepted in 2013-06-16,  发布年份 2013

【 摘 要 】

The UK NICE guideline on the Diagnosis and Assessment of Food Allergy in Children and Young People was published in 2011, highlighting the important role of primary care physicians, dietitians, nurses and other community based health care professionals in the diagnosis and assessment of IgE and non-IgE-mediated food allergies in children. The guideline suggests that those with suspected IgE-mediated disease and those suspected to suffer from severe non-IgE-mediated disease are referred on to secondary or tertiary level care. What is evident from this guideline is that the responsibility for the diagnostic food challenge, ongoing management and determining of tolerance to cow’s milk in children with less severe non-IgE-mediated food allergies is ultimately that of the primary care/community based health care staff, but this discussion fell outside of the current NICE guideline. Some clinical members of the guideline development group (CV, JW, ATF, TB) therefore felt that there was a particular need to extend this into a more practical guideline for cow’s milk allergy. This subset of the guideline development group with the additional expertise of a paediatric gastroenterologist (NS) therefore aimed to produce a UK Primary Care Guideline for the initial clinical recognition of all forms of cow’s milk allergy and the ongoing management of those with non-severe non-IgE-mediated cow’s milk allergy in the form of algorithms. These algorithms will be discussed in this review paper, drawing on guidance primarily from the UK NICE guideline, but also from the DRACMA guidelines, ESPGHAN guidelines, Australian guidelines and the US NIAID guidelines.

【 授权许可】

   
2013 Venter et al.; licensee BioMed Central Ltd.

【 图 表 】

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