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Meet Elizabeth

Elizabeth, a 5-year-old with a milk allergy, visits her healthcare professional for her annual check-up. Since 75% of children with cow’s milk allergy can tolerate baked foods containing milk,1,2 Elizabeth's healthcare professional suggested she should be tested with milk and to include milk component testing.

Patient History

Family history

  • None

Personal history

  • Diagnosed with eczema at her 6-month check up
  • Gastrointestinal distress, vomiting and eczema worsening after drinking milk at 3
  • Tested with pediatric allergy profile including foods and indoor respiratory allergens. Results confirmed sensitization to milk

Test Results

These results, together with this patient's case history and symptoms, help confirm the diagnosis.  

ImmunoCAPTM test results (kUA/l)
Test Type Results
Milk Whole Allergen 2.13
Bos d 4 (α-lactalbumin) Allergen Component 1.22
Bos d 5 (β-lactoglobulin) Allergen Component <.10 
Bos d 8 (casein) Allergen Component <.10

Differential Diagnosis

Elizabeth is sensitized to α-lactalbumin proteins. Her risk for reaction may be reduced when milk is thoroughly heated. She is not sensitized to casein proteins associated with severe reactions.1,2

Healthcare professional's management plan

  • Elizabeth's healthcare professional refers her to an allergy specialist for an oral food challenge with baked milk
  • The allergy specialist performs an oral baked milk challenge in the clinic, which Elizabeth passes without any symptoms.
  • The allergy specialist recommends that Elizabeth undergo retesting in about two years

Follow Up

Baked milk is now part of Elizabeth’s diet and she is doing well.

The people, places and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.

References
  1. Nowak-Wegrzyn A, et al. Tolerance to extensively heated milk in children with cow's milk allergy. J Allergy Clin Immunol. 2008;122:342-7.

  2. Caubet JC, et al. Utility of casein-specific IgE levels in predicting reactivity to baked milk. J Allergy Clin Immunol. 2013;131:222-4.