Asia Pac Allergy.  2018 Oct;8(4):e36. 10.5415/apallergy.2018.8.e36.

Cow's Milk-related Symptom Score as a predictive tool for cow's milk allergy in Indian children aged 0–24 months

• Prasad R
• Venkata RS
• Ghokale P
• Chakravarty P
• Anwar F

• KMID: 2423987
• DOI: http://doi.org/10.5415/apallergy.2018.8.e36

Abstract

BACKGROUND
Cow's milk protein causes an unfavorable and unwanted reaction in some individuals called cow's milk protein allergy (CMPA). It is more often imprecise and easily missed in primary care settings. Cow's Milk-related Symptom Score (CoMiSS) was developed as a screening and awareness tool to suggest the presence of CMPA using general, dermatological, gastrointestinal, and respiratory symptoms.
OBJECTIVE
Assess the utility of CoMiSS in the diagnosis of CMPA in Indian children aged between 0 and 24 months.
METHODS
A pilot multicentric, observational, longitudinal study was conducted over a period of 4 months among infants aged 0-24 months with symptoms suggestive of CMPA to measure the positive and negative predictive value of CoMiSS. A predesigned questionnaire was used to record the information via CoMiSS. The patients were confirmed of having CMPA via oral food challenge/skin prick test or ImmunoCAP test.
RESULTS
A total of 83 children were enrolled in the study and majority of them had gastrointestinal complaints (61%, 51 of 83) followed by respiratory (41%, 34 of 83) and skin complaints (33%, 27 of 83). CoMiSS was >12 in 72.3% of the infants and amongst them 84.3% were confirmed via oral food challenge/ImmunoCAP test. The positive and negative predictive values for CoMiSS were 93% and 33% respectively.
CONCLUSION
CoMiSS can help predict CMPA in children aged less than 2 years in the Indian primary care setting, aiding in early diagnosis. Prospective randomized studies are needed to evaluate the use of CoMiSS further.

Keyword

Cow's milk protein allergy; Cow's Milk-related Symptom Score; ImmunoCAP test; Child; Allergy

MeSH Terms

Child*
Diagnosis
Early Diagnosis
Humans
Hypersensitivity
Infant
Longitudinal Studies
Mass Screening
Milk Hypersensitivity*
Milk Proteins
Milk*
Primary Health Care
Prospective Studies
Skin
Milk Proteins