Introduction:The most prevalent food allergy in younger children is cow's milk protein allergy (CMPA), a hypersensitivity reaction to cow's milk protein and its most common clinical manifestation is allergic colitis. The goal of our recent study was to assess somatic symptoms of CMPA and to prospectively observe the effects of a dairy elimination diet using objective parameters and questionnaires.Methods:The County Hospital in Szekszárd, Hungary, investigated children aged 1 to 18 who had clinical signs that might indicate CMPA. Stool samples were taken and analyzed using a fecal calprotectin (FC) rapid test (Quantum Blue fCAL, Bühlmann Laboratories, Switzerland) at the time of the diagnosis and following 3 months of an elimination diet. At the baseline visit as well as the first and second follow-up, questionnaires were filled out. Patients were divided into two subgroups according to dietary guidelines based on the results of the questionnaires.Results:A total of 47 patients participated in the study [42.55% female, mean age: 7.36 (SD 4.22) years]. There was no significant difference in FC levels between baseline and after 3-month elimination diet [73.98 (71.12) μg/g and 68.11 (74.4) μg/g, respectively, p = 0.331]. After three months, there was a significant decrease in FC levels among patients who adhered to the strict diet [84.06 (79.48) μg/g and 41.11 (34.24) μg/g, respectively, p = 0.001].Conclusion:The findings of our study suggest that FC can be an objective marker in confirming the diagnosis of CMPA. Significant improvement in clinical symptoms and in FC levels can only be expected after a strictly followed elimination diet.

Introduction Food allergy in children is a frequent topic of clinical studies, considering the increasing number of the affected individuals and the diversity of the symptoms these children demonstrate. Cow’s milk protein allergy is the most common food allergy in the paediatric population, with an estimated prevalence of 2–6% in infants. Cow’s milk protein allergy can induce a variety of clinical symptoms, therefore establishing the correct diagnosis is often difficult. Beside the various clinical presentation, demographic and additional medical data of the research population and their families were also reviewed in this study. Methods The study was conducted at the Paediatric Gastroenterology Department of the Balassa János County Hospital in Szekszárd, Hungary. The research population (n=47) included children (0–18 years) with symptoms suggesting cow’s milk protein allergy. This component of our research represents the data from questionnaires filled in by the parents. The evaluation of the results was performed with SPSS statistical software. Results 47 children were included in our study (57.4% male, mean age: 7.36 years, SD: 4.22). By reviewing the parents’ medical history, 23.4% of mothers and 25.5% of fathers were diagnosed with either an atopic disease or an inflammatory bowel disease; however, examining the siblings of the affected children, 45,7% are reported to have one of these conditions (12 children do not have any siblings). In the study population, 8.5% were born prematurely and 85.1% were born at term (6,4% did not provide an answer). 46,8% were exclusively breastfed in the first 6 months of life. Analysing the data about the forms of clinical presentation, 85.1% showed gastrointestinal symptoms, 63.8% demonstrated skin-related problems, 57.4% presented with respiratory manifestation and 44.7% showed behavioural problems. Conclusion According to our results, a positive family history for atopic diseases and/or inflammatory bowel disease can increase the risk of developing cow’s milk protein allergy; siblings showed a higher prevalence of food allergy when the parents were affected by the aforementioned entities. The clinical manifestations represent a wide variety of symptoms which frequently overlap, making the diagnostic process often challenging. We did not observe a significant effect of feeding (breastfeeding or formula feeding), or being premature on the risk of developing cow’s milk protein allergy in children. However, it is important to emphasize the relatively small number of the study population, which is why we plan to continue the research with a larger study group.

Introduction Food allergies are very common in the pediatric population; the most common among them is cow’s milk protein allergy (CMPA). The clinical manifestations of this entity are diverse, thus establishing the diagnosis can be challenging. The aim of our human research is to evaluate and compare commonly performed diagnostic tests regarding CMPA. Methods Children with symptoms suggesting cow’s milk protein allergy were included in this study (n=47). The investigation was performed at the Balassa János County Hosptital in Szekszárd, Hungary. Stool samples were collected from the participating children at the time of the diagnosis, and after 3 months of elimination diet. On the first hospital visit, blood samples were drawn for lymphocyte transformation test (LTT), and a skin allergy test was also performed. On the first and third visit, parents were asked to fill in a questionnaire about the child’s symptoms, which was constructed by the research team. Stool samples were analysed with a fecal calprotectin (FC) rapid test. The lymphocyte transformation tests were conducted in an accredited university laboratory. Skin allergy testing was performed in the hospital setting. Evaluation of the data and the questionnaires was performed with SPSS statistical software. Results In the study population (n=47, mean age:7.36 years, 42.6% female), skin test was performed on 45 subjects; only 2 children (4.44%) showed positive test result for cow’s milk. Positive LTT was observed in 8 children (17%), 4 subjects demonstrated questionable results. Examining the entire research population, no significant difference in fecal calprotectin values was observed before (mean: 73.98 µg/g, SD: 71.12) and after (mean: 68.11 µg/g, SD: 74.04) the elimination diet (p=0.21). However, after dividing the participants into two subgroups according to the questionnaires, the following was observed: a significant decrease in FC values (p<0.001) was detected in children who strictly followed the diet (n=35) comparing the first (mean: 84.057 µg/g, SD: 79.48) and the second (mean: 41.114 µg/g, SD: 34.24) stool sample. Conclusion According to our research data, skin allergy testing and LTT are not reliable diagnostic tools for establishing the diagnosis of CMPA. However, fecal calprotectin can be an objective parameter in confirming the diagnosis of allergic colitis in children with CMPA. Significant improvement in clinical symptoms can only be expected after a strictly followed elimination diet.

Introduction The most common food allergy in children is cow’s milk protein allergy, and the clinical manifestations of the entity are very diverse. Beside the organic symptoms of milk protein allergy, behavioural problems often occur in these children: the parents describe problems with attention, increased impulsivity and sleeping disorder; the biological background of these symptoms in not fully understood at the moment. The aim of our human research is to examine the psychological aspects induced by these proteins. Methods Participants of the study were children above 3 years of age, with suggested symptoms of cow’s milk protein allergy (n=43). The location of the study was the Paediatric Gastroenterology Department of the Balassa János County Teaching Hospital. The parents of the involved children were asked to fill in a self-edited questionnaire, which contained questions about sociodemographical and health status, as well as features about behaviour (according to DSM-5 symptoms-cheklist about attention deficit-hyperactivity disorder). The evaluation of the questionnaires were performed with SPSS statistical program. Results Examining the entire research population (n=43, mean age:7.88 years, 41.9% female) the score received according to the ADHD symptoms-cheklist before the diet (6.88, SD: 4.43) showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p=0.001). The above mentioned score of the children with sleeping disorder (n=13, 10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p=0.009). Discussion According to our results it is found that psychological symptoms (attention deficit, hyperactivity, sleeping disorder) can be induced by cow’s milk protein allergy, but a significant improvement in these symptoms – beside the somatic symptoms - can only be achieved with a strict elimination diet.