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Hidden Allergens in Breast Milk

2010; Elsevier BV; Volume: 125; Issue: 2 Linguagem: Inglês

10.1016/j.jaci.2009.12.864

1097-6825

Magdalena Caminoa, M.F. Martín‐Muñoz, Fernando Pineda de la Losa, G. García-Parrado García, Irina Bobolea, Jesús Nicolás Larco Coloma, José Maria Díaz‐Pena, Santiago Quirce,

Eosinophilic Esophagitis

RATIONALE: Food allergy is a rare affection among breastfed children. Although cow's milk is the most important causative allergen, any other food allergen may be responsible for allergic reactions at that age. The aim of our study was to identify breast milk allergens involved in allergic reactions after breastfeeding. METHODS: We report on 5 children who developed urticaria or gastrointestinal symptoms after breastfeeding. Prick tests with breast milk, cow's milk, white egg and the foods ingested by the mother before the reaction were carried out. Total and specific IgE levels against the implicated food were measured (CAP system). IgE immunoblot techniques were performed with patients' serum and different samples of breast milk obtained before and after the intake of the specific foods implicated in the reactions. Finally, the clinical evolution of the patients was evaluated after establishing a maternal exclusion diet. RESULTS: Skin prick test and specific IgE determinations were positive with cow's milk (n=2), egg white (n=5), hake (n=1), or peanuts (n=2). The allergens responsible for the allergic reactions were identified by prick testing with breast milk and the immunoblot studies. Immunoblot revealed several IgE-binding bands in breast milk after the intake of peanut, white egg or cow's milk. These bands showed molecular masses that might correspond with allergens from peanut, egg white or cow's milk, which were absent before the ingestion of these foodstuffs. After the mothers started exclusion diets the infants remained asymptomatic. CONCLUSIONS: Woman breast milk should be considered a source of hidden allergens in infants with allergic reactions.