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Consensus statement on the epidemiology,diagnosis,prevention,and management of cow's milk protein allergy in the Middle East:a modified Delphi-based study

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World Journal of Pediatrics 2021年第6期17卷 576-589页

作者： Moustafa A.El-Hodhod Mortada H.F.El-Shabrawi ahmed aibadi ahmed Hussein AM Almehaidib Basil Nasrallah Ebtsam Mohammed AIBassam Hala El Feghali Hasan M.Isa Khaled Al Saraf Maroun Sokhn Mehdi Adeli Najwa Mohammed Mousa Al-Sawi Pierre Hage Suleiman Al-Hammadi Department of Pediatrics Faculty of MedicineAin Shams UniversityCairoEgypt Faculty of Medicine October 6 UniversityGizaEgypt Faculty of Medicine Cairo UniversityCairoEgypt International Pediatric Association(IPA) MarengoUSA International Society of Tropical Pediatrics(ISTP) ManilaPhilippines DRC Hospital MuscatOman Al Amiri and Al Adan Hospitals KuwaitKuwait Pediatric Gastroenterology Department of PediatricsKing Faisal Specialist Hospital and Research Center RiyadhRiyadhSaudi Arabia American Hospital Dubai DubaiUnited Arab Emirates Nutrition Service Department King Faisal Specialist and Research Center RiyadhRiyadhSaudi Arabia CHU Notre Dame de Secours ByblosLebanon Pediatric Department Salmaniya Medical ComplexManamaBahrain Pediatric department Arabian Gulf UniversityManamaBahrain Pediatrics Department Dar Al Shifa HospitalKuwaitKuwait Pediatric Gastroenterology Hepatologyand Nutrition DepartmentSaint George University Medical CenterUniversity of BalamandBeirutLebanon Sidra Medicine DohaQatar Department of Pediatrics Doctor Sulaiman Alhabib Medical GroupAlrryan BranchRiyadhSaudi Arabia Pediatric Pulmonology and Allergology University of BalamandBeirutLebanon College of Medicine Mohanuned Bin Rashid University of Medicine and Health SciencesBuilding 14505055 DubaiUnited Arab Emirates

Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle *** A three-step modified Delphi method was utilized to develop the *** specialized pediatricians participated in the development of this *** statement was considered a consensus if it achieved an agreement level of>80%.Results The experts agreed that the double-blind placebo-controlled oral challenge test(OCT)should be performed for 2-A weeks using an amino acid formula(AAF)in formula-fed infants or children with suspected ***-fed infants with confirmed CMPA should be offered a therapeutic *** panel stated that an extensively hydrolyzed formula(eHF)is indicated in the absence of red flag *** the same time,the AAF is offered for infants with red flag signs,such as severe anaphylactic *** panel agreed that infants on an eHF with resolved symptoms within 2-4 weeks should continue the eHF with particular attention to the growth and nutritional *** the other hand,an AAF should be considered for infants with persistent symptoms;the AAF should be continued if the symptoms resolve within 2-4 weeks,with particular attention to the growth and nutritional *** cases with no symptomatic improvements after the introduction of an *** measures should be *** panel developed a management algorithm,which achieved an agreement level of 90.9%.Conclusion This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.

关键词： Consensus Cow's milk protein allergy Infant formula Middle East Milk hypersensitivity

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