ALLERGIE AUX PROTEINES DE LAIT DE VACHE Description des Aspects Clinico-Biologiques lors du Diagnostic, de la Prise en Charge et du Suivi de l’APLV chez les Enfants

Abstract

The main objective of our study is the description of the different clinico-biological aspects during the diagnosis, management and monitoring of CMPA in children by exploring the involvement of certain factors in the development of this allergy. Material and methods: A descriptive study of 40 cases of APLV reported in a pediatric ward over a period of 3 months was carried out, based on information collected using a form and the results of a series of Prick tests and specific IgE tests performed. Results : A male predominance of 55% was noted in our study. The majority of our cases (68.75%) were exposed to CMP at a very young age (≤30 days). The exposure rate decreased with increasing age. The mean age of introduction of CMP was 19.6 days. In our patients the average age of onset of the disorders after ingestion of CM is around 2.76 months. The minimum age of appearance of the first symptoms is in the first postnatal days, while the maximum age is 7 months. 50% of the population was exclusively breastfed. The notion of a first sensitizing bottle was described in 45% of cases. 40% of the mothers reported having taken medication during pregnancy, with a majority rate of 26.91% of vitamin supplementation (folic acid and others). The most frequent clinical signs were digestive signs with a rate of 56%. The notion of atopy was described in 52.5% of the recruited population, 25% of whom had an atopic parent. Respiratory allergies (asthma, rhino conjunctivitis…) represent the major form of atopy in our patients with a rate of 67%. 19 specific IgE tests to CMP were performed of which 47.36% were positive. Among all our patients, 22% of cases of IgE-mediated CMPA were reported against 78% non-IgE-mediated. 28 Prick tests were performed of which 36% were positive indicating sensitization to CM. The presence of β-Lactoglobulin was found in 100% of the positive samples, α-Lactalbumin, caseins and serum bovine albumin were found in 78% of the cases, and lactoferrin was found in 11% of the positive cases. During the CMP avoidance phase, 60% of the cases substituted these proteins by artificial preparations of which a majority of 91.66% was eHF. Conclusion: The results of our study are an addition to those already made about CMPA in the national territory