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Open AccessArticle

Milk-Related Symptoms and Immunoglobulin E Reactivity in Swedish Children from Early Life to Adolescence

Center for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, 171 76 Stockholm, Sweden
Sachs’ Children and Youth Hospital, The South General Hospital, 118 83 Stockholm, Sweden
Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institute, 118 83 Stockholm, Sweden
Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet, and Karolinska University Hospital, 171 76 Stockholm, Sweden
Centre for Clinical Research Sörmland, Uppsala University, 751 85 Eskiltuna, Sweden
Author to whom correspondence should be addressed.
Nutrients 2018, 10(5), 651;
Received: 5 April 2018 / Revised: 1 May 2018 / Accepted: 1 May 2018 / Published: 21 May 2018
(This article belongs to the Special Issue Contributions of Diet and Gastrointestinal Digestion to Food Allergy)
Cow’s milk often causes symptoms in infants. Whereas, some continue to experience symptoms through childhood, others become tolerant. Yet, the ages at which persistence and tolerance occur are less clear. Thus, we examined the age of onset and persistence of milk-related symptoms from early life to adolescence, and Immunoglobulin E (IgE) milk reactivity, focusing on gender differences in a large, population-based birth cohort. Overall, 20.0% (537/2985) of children, with a comparable gender distribution, had early life milk-related symptoms. At 16y, approximately 2% (62/2985) children had persistent symptoms and high milk IgE levels (e.g., median at 4 years: 1.5 kUA/L) that were beginning in early life. In contrast, 94% had transient symptoms and low median IgE levels (early life: 0.63 kUA/L, 8y: 0.72 kUA/L; 16 years: 1.1 kUA/L). Also, at 16 years, approximately 6% of females and 3% of males without any previously reported symptoms reported adolescent-onset of symptoms (p < 0.001). Such symptoms were almost exclusively gastrointestinal symptoms and were not associated with detectable IgE. In conclusion, early life milk-related symptoms are common, although most cases are transient by 16 years. Twice as many females vs. males report adolescent-onset symptoms, and particularly gastrointestinal symptoms. Children with persistent symptoms have both a higher prevalence and higher milk IgE levels, as compared to other phenotypes. View Full-Text
Keywords: adolescent; allergy; anaphylaxis; child; food hypersensitivity; Immunoglobulin E; milk adolescent; allergy; anaphylaxis; child; food hypersensitivity; Immunoglobulin E; milk
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Protudjer, J.L.P.; Olén, O.; Vetander, M.; Kull, I.; Melén, E.; Van Hage, M.; Wickman, M.; Bergström, A. Milk-Related Symptoms and Immunoglobulin E Reactivity in Swedish Children from Early Life to Adolescence. Nutrients 2018, 10, 651.

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