Milk allergy/intolerance and atopic dermatitis in infancy and childrem

Adverse reactions to cow’s milk proteins are usually indicated as cow’s milkallergy/intolerance (CMPA/CMPI) because no differentiation is possible on thebasis of symptoms, and there is no reliable single laboratory test available for thediagnosis of CMPA or CMPI. Elimination and challenge tests for cow’s milkproteins using strict, well-defined diagnostic criteria are required for thediagnosis of CMPA/CMPI. Atopic dermatitis (AD) is one of the most commonsymptoms of CMPA/CMPI. Approximately one third of AD children have adiagnosis of CMPA /CMPI according to eliminat ion diet an d challenge tests, andabout 40–50% of children <1 year of age with CMPA/CMPI have AD. Manychildren with AD and CMPA/CMPI develop a complete tolerance to CMP in afew years. Children with persisting forms of CMPA/CMPI have a more frequenthistory of familial atopic disease, change in CMPA/CMPI manifestations overtime and very high frequency of multiple food intolerance and allergic diseases.Many children who outgrow their AD develop other allergic diseases, such asrhinitis or asthma. The simultaneous developm ent of allergic tolerance in oneorgan and the intolerance or atopic disease in another organ suggest that genetic,immunologic and environmental factors play a complex role in the na turalhistory of AD and other atopic diseas