Allergy
ORIGINAL ARTICLE
EPIDEMIOLOGY AND GENETICS
Incidence and natural history of challenge-proven cow’s milk allergy in European children – EuroPrevall birth cohort A. A. Schoemaker1,*, A. B. Sprikkelman1,*, K. E. Grimshaw2,*, G. Roberts2,3, L. Grabenhenrich4, L. Rosenfeld5, S. Siegert5,6, R. Dubakiene7, O. Rudzeviciene7, M. Reche8, A. Fiandor9, N. G. Papadopoulos10, A. Malamitsi-Puchner11, A. Fiocchi12, L. Dahdah12, S. Th. Sigurdardottir13, czyk-Przyłuska15, K. Zeman15,16, E. N. C. Mills17, D. McBride4, T. Keil4,18 & M. Clausen14, A. Stan 5 K. Beyer 1
Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands; 2Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton; 3NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK; 4Institute of Social Medicine, University Medical Centre; 5Department of Paediatric Pneumology and Immunology, Charite Epidemiology and Health Economics, Charite University Medical Centre; 6German Agency for Quality in Medicine, Berlin, Germany; 7Faculty of Medicine, Vilnius University, Vilnius, Lithuania; 8Sofia Children’s University Hospital; 9University Hospital La Paz, Madrid, Spain; 10Department of Allergy, Second Paediatric Clinic, University of Athens; 11Neonatal Division, Second Department of Obstetrics and Gynaecology, University of Athens, Athens, Greece; 12 , Rome, Italy; 13Department of Immunology, Landspitali-The Division of Allergy, Department of Pediatrics, Pediatric Hospital Bambino Gesu 14 National University Hospital of Iceland; Children’s Hospital, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland; 15 dz, Poland; 16Department of Pediatrics, Department of Pediatrics, Preventive Cardiology and Immunology, Medical University of Ło dz, Poland; 17Institute of Inflammation and Repair, Immunology and Nephrology, Polish Mother’s Health Centre Research Institute Ło Manchester Academic Health Science Centre, Manchester Institute of Biotechnology, University of Manchester, Manchester, UK; 18Institute €rzburg, Wu €rzburg, Germany of Clinical Epidemiology and Biometry, University of Wu
To cite this article: Schoemaker AA, Sprikkelman AB, Grimshaw KE, Roberts G, Grabenhenrich L, Rosenfeld L, Siegert S, Dubakiene R, Rudzeviciene O, Reche czyk-Przyłuska A, Zeman K, Mills ENC, McBride M, Fiandor A, Papadopoulos NG, Malamitsi-Puchner A, Fiocchi A , Dahdah L, Sigurdardottir STh, Clausen M, Stan D, Keil T, Beyer K. Incidence and natural history of challenge-proven cow’s milk allergy in European children – EuroPrevall birth cohort. Allergy 2015; 70: 963–972.
Keywords birth cohort study; cow’s milk allergy; EuroPrevall; food allergy; incidence. Correspondence Kate E. Grimshaw, Clinical Experimental Science Academic Unit, Mailpoint 803, Level F, South Academic Block, Southampton General Hospital Tremona Road, Southampton SO16 6YD, UK. Tel.: 2381206160 Fax: 2380878847 E-mail: [email protected] *Contributed equally to the manuscript as first authors. Accepted for publication 6 April 2015 DOI:10.1111/all.12630 Edited by: Antonella Muraro
Abstract Background: Cow’s milk allergy (CMA) is one of the most commonly reported childhood food problems. Community-based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria. Methods: Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cow’s milk-specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double-blind, placebo-controlled food challenge. Results: Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge-proven CMA of 0.54% (95% CI 0.41–0.70). National incidences ranged from 1% (in the Netherlands and UK) to
ORIGINAL ARTICLE
EPIDEMIOLOGY AND GENETICS
Incidence and natural history of challenge-proven cow’s milk allergy in European children – EuroPrevall birth cohort A. A. Schoemaker1,*, A. B. Sprikkelman1,*, K. E. Grimshaw2,*, G. Roberts2,3, L. Grabenhenrich4, L. Rosenfeld5, S. Siegert5,6, R. Dubakiene7, O. Rudzeviciene7, M. Reche8, A. Fiandor9, N. G. Papadopoulos10, A. Malamitsi-Puchner11, A. Fiocchi12, L. Dahdah12, S. Th. Sigurdardottir13, czyk-Przyłuska15, K. Zeman15,16, E. N. C. Mills17, D. McBride4, T. Keil4,18 & M. Clausen14, A. Stan 5 K. Beyer 1
Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands; 2Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton; 3NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK; 4Institute of Social Medicine, University Medical Centre; 5Department of Paediatric Pneumology and Immunology, Charite Epidemiology and Health Economics, Charite University Medical Centre; 6German Agency for Quality in Medicine, Berlin, Germany; 7Faculty of Medicine, Vilnius University, Vilnius, Lithuania; 8Sofia Children’s University Hospital; 9University Hospital La Paz, Madrid, Spain; 10Department of Allergy, Second Paediatric Clinic, University of Athens; 11Neonatal Division, Second Department of Obstetrics and Gynaecology, University of Athens, Athens, Greece; 12 , Rome, Italy; 13Department of Immunology, Landspitali-The Division of Allergy, Department of Pediatrics, Pediatric Hospital Bambino Gesu 14 National University Hospital of Iceland; Children’s Hospital, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland; 15 dz, Poland; 16Department of Pediatrics, Department of Pediatrics, Preventive Cardiology and Immunology, Medical University of Ło dz, Poland; 17Institute of Inflammation and Repair, Immunology and Nephrology, Polish Mother’s Health Centre Research Institute Ło Manchester Academic Health Science Centre, Manchester Institute of Biotechnology, University of Manchester, Manchester, UK; 18Institute €rzburg, Wu €rzburg, Germany of Clinical Epidemiology and Biometry, University of Wu
To cite this article: Schoemaker AA, Sprikkelman AB, Grimshaw KE, Roberts G, Grabenhenrich L, Rosenfeld L, Siegert S, Dubakiene R, Rudzeviciene O, Reche czyk-Przyłuska A, Zeman K, Mills ENC, McBride M, Fiandor A, Papadopoulos NG, Malamitsi-Puchner A, Fiocchi A , Dahdah L, Sigurdardottir STh, Clausen M, Stan D, Keil T, Beyer K. Incidence and natural history of challenge-proven cow’s milk allergy in European children – EuroPrevall birth cohort. Allergy 2015; 70: 963–972.
Keywords birth cohort study; cow’s milk allergy; EuroPrevall; food allergy; incidence. Correspondence Kate E. Grimshaw, Clinical Experimental Science Academic Unit, Mailpoint 803, Level F, South Academic Block, Southampton General Hospital Tremona Road, Southampton SO16 6YD, UK. Tel.: 2381206160 Fax: 2380878847 E-mail: [email protected] *Contributed equally to the manuscript as first authors. Accepted for publication 6 April 2015 DOI:10.1111/all.12630 Edited by: Antonella Muraro
Abstract Background: Cow’s milk allergy (CMA) is one of the most commonly reported childhood food problems. Community-based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria. Methods: Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cow’s milk-specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double-blind, placebo-controlled food challenge. Results: Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge-proven CMA of 0.54% (95% CI 0.41–0.70). National incidences ranged from 1% (in the Netherlands and UK) to
