Cow’s milk protein allergy in children with epidermolysis bullosa

Background. Impaired skin and epithelial barrier function from the first days of life in children with epidermolysis bullosa can cause sensitization, including food sensitization. Objective. Evaluation of the features of the IgE response to cow’s milk proteins and the clinical manifestations of cow’s milk protein allergy (CMPA) in children with epidermolysis bullosa. Methods. 82 children with epidermolysis bullosa (60 children with dystrophic form and 22 with a simple form of the disease) were examined. Diagnosis of CMPA was based on a generally accepted set of clinical and laboratory methods (medical history, nature of clinical manifestations, diagnostic milk-free diet, open provocative test). The level of cow’s milk specific IgE and its fractions (casein, в-lactoglobulin, bovine serum albumin) was determined using the indirect immunofluorescence (ImmunoCAP250). Results. Sensitization to cow’s milk proteins, casein, and bovine serum albumin was detected statistically significantly more often in children with dystrophic form of epidermolysis bullosa compared to simple form (p<0.05). In the group of children with dystrophic form of epidermolysis bullosa, CMPA was diagnosed in 11 cases, which amounted to 17.7%, and clinically significant CMPA was diagnosed in 25% of cases. Among children with a simple form of epidermolysis bullosa, clinical reactions to food were detected in 2 (9.1%) patients. Conclusion Children with a dystrophic form of epidermolysis bullosa are characterized by a higher frequency of sensitization to milk proteins and clinically significant CMPA.

IgE, epidermolysis bullosa, children, cow's milk protein allergy, IgE