Antonio and Isabel, 18-month-olds who both have a history of eczema and milk allergy, visit their healthcare provider for additional insight into their milk allergy.
Antonio and Isabel's healthcare provider conducts a full clinical history and physical examination and decides to test using milk whole allergen with component reflex.
Antonio and Isabel were both diagnosed with milk allergy. But allergies can change over time.
Test |
Type |
Antonio Results |
Isabel Results |
Milk |
Whole Allergen |
+4 |
+5 |
Antonio and Isabel had a negative skin-prick test to egg.
Test |
Type |
Antonio Results |
Isabel Results |
Milk |
Whole Allergen |
18 |
25 |
Based on history, evaluation, and testing their previous healthcare provider recommended that eliminating cow’s milk from the diet and substitute with milk-free formula.
These results together with this patient's case history and symptoms, help confirm the diagnosis.
Test |
Type |
Antonio's Results |
Isabel's Results |
Milk |
Whole Allergen |
10.2 |
20.6 |
Bos d 4 (α-lactalbumin) |
Allergen Component |
3.8 |
2.2 |
Bos d 5 (β-lactoglobulin) |
Allergen Component |
0.7 |
1.0 |
Bos d 8 (casein) |
Allergen Component |
1.4 |
21.5 |
Antonio’s low level of sensitization to Bos d 8 casein indicates he may have a tolerance to extensively heated milk. An oral challenge with extensively heated milk may be performed to confirm the diagnosis. With components and follow-up oral challenge, Antonio’s quality of life could have been improved: No need of strict avoidance of milk and no cause of stress in the family due to the risk of eating products containing extensively heated milk, such as cakes and cookies.1,2
REFINED DIAGNOSIS
HEALTHCARE PROVIDER MANAGEMENT PLAN
FOLLOW UP
Isabel’s significant levels of IgE to Bos d 8 indicates a risk for severe reaction to all forms of milk.1,2
REFINED DIAGNOSIS
HEALTHCARE PROVIDER MANAGEMENT PLAN
FOLLOW UP
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