CHRONIC DIARRHEA DUE TO COW'S MILK ALLERGY (CMA) A 4-10 YEAR FOLLOW-UP

It is generally agreed that chronic diarrhea due to CMA resolves with a cow's milk (CM)-free diet, and that tolerance to CM is achieved by two years of age. We have followed-up to 4-10 years 41 infants with chronic diarrhea due to CMA, who had at onset of diarrhea RAST and/or skin tests positive to CM. The infants were given a lamb diet prepared as follows (per liter): meat 100g, rice flour 70 g, olive oil 40 g, table salt 2 g. After the diarrhea subsided, the CM-reintroduction was attempted at 6-month intervals. In 25/37 (67.5%) children (4 cases were lost in the follow-ups) CMA resolved at a median age of two years, whereas 12/37 (32.5%) children do not yet tolerate CM at a median age of 6 years. In addition, a large proportion of children (27/37=73%) suffered during the follow-up period from other atopic symptoms, due either to CMA or to inhalant allergy. However, females appear to be either more prone to develop tolerance to CM, or less affected by other atopic diseases. 15/17 males and 12/20 females developed other atopic diseases. Our data suggest that in infants with chronic diarrhea due to CMA, RAST and/or skin tests positive to CM may indicate either the tendency of CMA to persist throughout childhood, or the risk of developing other atopic disorders.