Cow's Milk Related Symptoms Score (COMISS) As a Predictor for Cow's Milk Allergy: An Interventional Study

1Azza Ibrahim El Desouky, HebaGamalAnany, Ibrahim Sobhy Ibrahim Mohammed

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Abstract:

Background:Primary health care physicians are insufficiently aware of symptoms caused by cow milk because there is no pathognomonic symptom and no reliable diagnostic test, which results in repeated consultations and inaccurate management.Due to the lack of other reliable diagnostic tests other than a food challenge with cow milk protein, infants suspected of suffering from cow's milk protein allergy (CMPA), developing an awareness tool to recognize cow's milk related symptoms in infants and young children for use.A Cow's Milk-related-Symptom-Score (CoMiSS ), a score that considers general manifestations, dermatological, gastrointestinal and respiratory symptoms, was developed to be used as an awareness tool for cow's milk related symptoms. The study aimed to assess the value of Cow's milk related symptoms score (COMISS) in the prediction of cow's milk allergy in pediatrics. Methods:This study was conducted during at Pediatric Department, Faculty of Medicine, Zagazig University. This study was interventional one which included 120 infants (aged up to 18 month) presenting with one or more of the following CMPA symptoms: cutaneous (atopic dermatitis and urticaria), respiratory (cough and dyspnea, rhinitis), and gastrointestinal (digestive regurgitation, vomiting, rectal bleeding, constipation and diarrhea). A predesigned questionnaire, with informed consent obtained from parent/primary care giver of the infant, was used to collect information pertaining to the general characteristics and anthropometry, medical and feeding history and clinical examination via CoMiSS.Results:There was statistically significant lower in Albumin among Confirmed CMA than No CMA. There was statistically significant higher Total score of CoMiSS among Confirmed CMA than No CMA, and another one regarding each symptom of COMISS score.Conclusion: Accuracy of CoMiSS in diagnosis of CMA was 90.8%. the percentage of Sensitivity (86.4%), Specificity (93.4%), Positive predictive value % (88.3%) when the score is >12 Negative predictive value % (92.2%).

Keywords:

Cow's milk related symptoms score- cow's milk allergy in pediatrics- Evaluation

Paper Details
Month12
Year2020
Volume24
IssueIssue 10
Pages7012-7019