REV.CHIM.(Bucharest)♦69♦No. 12 ♦2018 http://www.revistadechimie.ro 3573 Assessment of Clinicopathological Features in Infants and Children with Cow’s Milk Protein Allergy ILEANA PUIU 1 , ELENA CATALINA BICA 1 , VENERA CRISTINA DINESCU 2 *, OTILIA CONSTANTINA ROGOVEANU 3 , ALEXANDRA OLTEA DAN 4 , RAMONA CONSTANTINA VASILE 5 , SORIN NICOLAE DINESCU 5 , FLORIN MARIUS ROMANESCU 6 , ELENA ANCA TARTEA 7 , DIANA RODICA TUDORASCU 8 1 University of Medicine and Pharmacy of Craiova, Pediatrics Department, 2 Petru Rares Str., 200349 Craiova, Romania 2 University of Medicine and Pharmacy of Craiova, Health Promotion and Occupational Medicine Department, 2 Petru Rares Str., 200349, Craiova, Romania 3 University of Medicine and Pharmacy of Craiova, , Department of Physical and Rehabilitation Medicine, 2 Petru Rares Str., 200349, Craiova, Romania 4 University of Medicine and Pharmacy of Craiova, Ophthalmology Department, 2 Petru Rares Str., 200349, Craiova, Romania 5 University of Medicine and Pharmacy of Craiova, Epidemiology and Primary Health Care Department, 2 Petru Rares Str., 200349, Craiova, Romania 6 University of Medicine and Pharmacy of Craiova, Department of Physiology, 2 Petru Rares Str., 200349, Craiova, Romania 7 University of Medicine and Pharmacy of Craiova, Neurology Department, 2 Petru Rares Str., 200349 ,Craiova, Romania 8 University of Medicine and Pharmacy of Craiova, Internal Medicine Department, 2 Petru Rares Str., 200349, Craiova, Romania The aim of our study was to evaluate the clinicopathological features in infants and young children with cow’s milk protein allergy. Cow’s milk protein allergy (CMPA) is one of the most common food allergy in children. Thus, we conducted a descriptive observational study, which was carried out in the First Pediatric Clinic of the Craiova County Emergency Clinical Hospital, in the period 2015-2017, which included 138 infants and young children diagnosed with cow’s milk protein allergy. An improvement in digestive symptomatology during the status period of the disease was observed, especially in what diarrheal stools are concerned as their incidence has decreased. In fact, gastroesophageal reflux is the most common manifestation in infants and children with CMPA, while mean acute otitis is present only in a small number of patients. In conclusion we can say that a good knowledge of the clinicopathological features in children with allergy to cow’s milk proteins allows a superior therapeutic attitude and ensures a normal life for children and infants suffering from this type of allergy. Key words: cow’s milk protein allergy, infants and children Cow’s milk protein allergy (CMPA) is one of the most common food allergies in children and it has a prevalence of about 1.9 - 4.9% in infants and children under 3 years old [1-3]. It should be specified that allergy is a hypersensitivity reaction initiated by specific immunological mechanisms [1]. In accordance with the National Institute of Allergy and Infectious Disease (NIAID), food allergies are classified in immunoglobulin E (IgE) mediated allergies, non-IgE- mediated and also in mixed IgE and non-IgE-mediated [4]. In the majority of infants and children with CMPA the immunologic mechanisms produce IgE in response to the ingestion of cow’s milk protein and this is considered an atopy manifestation with or in the absence of other signs such as astma, allergic rhinitis and eczema [1]. IgE-mediated CMPA defense symptom during the first two hours after the ingestion of cow’s milk and may affect the gastrointestinal system, the respiratory system and the skin, potentially life-threatening anaphylaxis reactions may occur [2, 4]. Also, although rarer than IgE-mediated CMPA, in non-IgE-mediated CMPA, symptomatology occurs later, at about 72 h after the ingestion of cow’s milk, and most often includes gastrointestinal events such as gastroesophageal reflux, diarrhea, blood stools or constipation [1]. In E-immunoglobulin-mediated allergy, certain antibody- dependent protein structures recognize certain molecular regions of other interacting structures (epitopes). Because it is not secreted in human milk, beta-lactoglobulin (BLG) has long been considered the most allergenic component * email: veneradi@yahoo.com, Phone: 0740492161 All the authors contributed equally to the manuscript and share first authorship of cow’s milk, but at present many proteins appear to be involved in this immunological response [1]. The CMPA diagnosis is based primarily on identifying symptoms and on linking them to possible foods suspected of being responsible for immunological mechanisms adjacent to allergy [5]. The skin prick test or specific IgE blood test are useful for the diagnosis of IgE-mediated CMPA while for non-IgE-mediated CMPA are limited [5,6]. However, the oral challenge test remains the gold standard for the two types of allergies [5,6]. Progressive administration in small and repetitive amounts of cow’s milk proteins allows better immunity tolerance than with massive ingestion, most children regaining tolerance to cow’s milk around the age of 3-4 years [1]. Experimental part The aim of the study The aim of our study was to evaluate the clinicopathological features in infants and young children with cow’s milk protein allergy. Material and methods Thus, we conducted a descriptive observational study, which was carried out in the First Pediatric Clinic of the Clinical Emergency County Hospital of Craiova, between 2015-2017, the study included 138 infants and young children diagnosed with cow’s milk protein allergy.