Cow's Milk-Related Symptom Score (Comiss) And Nutritional Status In Egyptian Infants With Non-Ige Cow's Milk Protein Allergy: A Single Center Experience

Abstract

Background: Approximately 2% to 3% of children under four years old are affected by cow's milk allergy (CMA), which is the most difficult food allergy to identify since the clinical symptoms can vary widely in terms of kind and severity. CMA usually first appears in the first year of life. Along with allergies to eggs and peanuts, it is therefore one of the most common food allergies in children, and like other food allergies, its prevalence is predicted to rise. Between November 2021 and February 2023, a prospective cohort research was carried out at the Gastroenterology clinic at Cairo University's Children Hospital on a random sample of 300 children who had symptoms suggestive of non-Ig E CMPA. The purpose of the study was to evaluate the nutritional status and validate the change in Cow’s Milk Related Symptom Score (CoMiSS) in Egyptian children with non-Ig E CMPA. Results: The optimal cut-off point, according to our research, is a CoMiSS score of ≥12. CoMiSS by itself, however, is insufficient for a precise diagnosis of CMPA. The risk of non-Ig E mediated CMPA was protected by exclusive breastfeeding, but age ≤12 months, atopic eczema score >2, and CoMiSS≥12 were linked to positive OFC, whereas NICU admission and a positive family history of allergy were linked to andCoMiSS≥12. Patients with CoMiSS ≥ 12 had significantly reduced Weight-for-age z-score, weight-for-height Z-score, and mid upper arm circumference. The most common kind of malnutrition linked to positive Oral food challenge was moderate acute malnutrition. Conclusion: CoMiSS is a useful method for identifying infants who exhibit non-Ig E-mediated CMPA symptoms. The optimal cut-off point, according to our research, is a CoMiSS score of ≥12. For a precise diagnosis of CMPA, CoMiSS by itself is insufficient. Infants exhibiting signs of CMPA should be managed with nutritional evaluation and the identification of various types of malnutrition.