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  • Title: The effect of follow-up after a negative double-blinded placebo-controlled cow's milk challenge on successful reintroduction.
    Author: Schrijvers M, Hendriks T, Mars H, Bertrams-Maartens IA.
    Journal: Eur J Pediatr; 2019 Jul; 178(7):1113-1117. PubMed ID: 31127359.
    Abstract:
    Cow's milk allergy is a common food allergy in children with an incidence of 1-3%. The gold standard to diagnose cow's milk allergy is a double-blinded placebo-controlled food challenge (DBPCFC). Previous studies show that reintroduction of cow's milk is unsuccessful in 10-12% of patients. The aim of this retrospective study is to evaluate the effect of follow-up on the reintroduction of cow's milk. We analyzed the data of patients with a negative DBPCFC for cow's milk between 2014 and 2016 in three different departments. Questionnaires were used to compare the three ways of follow-up (no follow-up, follow-up in person or by telephone). Of the 336 children with a negative DBPCFC for cow's milk, 128 questionnaires (41%) were returned. Reintroduction of cow's milk was unsuccessful in 13.3% of the patients. There was no significant difference found between children with (73.8%) or without (26.2%) follow-up, or between follow-up by phone or personally. Whether this finding is caused by small numbers within this retrospective study should be investigated in future prospective studies.Conclusion: Follow-up does not influence the reintroduction success rate of cow's milk after a negative double-blinded placebo-controlled food challenge. What is Known: Diagnosis of cow's milk allergy by double-blinded placebo-controlled food challenge is the gold standard. • After a negative double-blinded placebo-controlled food challenge, reintroduction of cow's milk in the child's diet is unsuccessful in 10-12% of the children. • Recurrence of symptoms, aversion to the examined food, and fear are seen as the main reasons for unsuccessful introduction. What is New: • Reintroduction after a negative double-blinded placebo-controlled food challenge is not influenced by different ways of follow-up.
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