[Acquired IGE Mediated Milk Protein Allergy in Children with Atopic Diseases, after Cow`s Milk Elimination Diet - A Case Series Presentation].

Approximately 30% - 40% of children with moderate-to-severe atopic dermatitis (AD) have IgE-mediated food allergy (FA). Although food avoidance may improve AD, avoidance diets do not cure AD and may even have detrimental effects such as progression to immediate-type allergy including anaphylactic reaction. An avoidance diet is only indicated in patients clearly identified as food allergic by an appropriate diagnostic food test and oral food challenge test. Eosinophilic esophagitis (EOE) patients have a history of atopic disease. EOE symptoms are characterized depending on the age of the patient, such as vomiting, failure to thrive and food impaction. The first offered treatment is an elementary diet and a cow milk elimination diet. We present a case series of 2 to 5 year old children with AD or EOE in whom the milk protein elimination diet promoted IgE sensitization, an allergic reaction, and even anaphylaxis. There is a considerable chance of developing acute allergic reactions to cow milk protein (CMP), after elimination, in children with AD and EOE, who previously consumed CMP. Allergists, gastroenterologists and pediatricians should be aware of this risk, and promote patient safety through education.