{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T18:22:52Z","timestamp":1764872572013,"version":"3.41.2"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cow's milk protein allergy (CMPA) remains relatively understudied in Latin America.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this observational study, we enrolled 64 patients with a median age of 3 months, of whom 60% were male. Patients included had a history of IgE\u2010mediated reactions with IgE sensitization or non\u2010IgE\u2010mediated reactions or symptoms following exposure to cow's milk. They underwent skin prick test, ImmunoCAP, fecal calprotectin (FC), and fecal eosinophil\u2010derived neurotoxin (EDN), in addition to double\u2010blinded placebo\u2010controlled oral food challenges (DBPCFC), with clinical evolution and tolerance acquisition observed over 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Malnutrition was present in 78.1% of patients, and 87.5% had a family history of atopy, with 51.6% receiving exclusive breastfeeding. Gastrointestinal manifestations were prevalent in 90.6% of patients, followed by dermatological manifestations (10.9%), with only 2 experiencing anaphylaxis. IgE\u2010mediated CMPA was observed in only six patients. In those with non\u2010IgE\u2010mediated CMPA, FC had a median of 284 mg\/dL (IQR: 138.5\u2013415.5), while EDN had a median of 508.5 mg\/dL (IQR: 160.25\u2013868). One year after diagnosis, median FC significantly decreased (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and malnutrition prevalence reduced to 17.1%. Moreover, 81% of patients acquired tolerance following DBPCFC, with 52% utilizing nutritional replacement formulas at diagnosis. Notably, 94% of those extensively hydrolyzed casein\u2010based formulas achieved tolerance (<jats:italic>p<\/jats:italic>\u2009=\u20090.08).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings provide a foundational framework for future investigations into CMPA diagnosis, tolerance acquisition, and the utilization of hypoallergenic formulas tailored to the unique characteristics of our region.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iid3.1246","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T14:49:45Z","timestamp":1714142985000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical characteristics, laboratory findings, and tolerance acquisition in infants with cow's milk protein allergy in a private center in Lima, Peru for the period 2021\u20132022"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3517-3051","authenticated-orcid":false,"given":"C\u00e9sar Galv\u00e1n","family":"Calle","sequence":"first","affiliation":[{"name":"Asthma Allergy and Immunology Instituto Nacional de Salud del Ni\u00f1o\u00a0\u2013 Bre\u00f1a Bre\u00f1a Lima Peru"},{"name":"Instituto latinoamericano de Alergias Asma e Inmunologia (ILAAI) Lince Lima Peru"},{"name":"Emedic Salud San Isidro Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"D\u00edaz\u2010V\u00e1squez","sequence":"additional","affiliation":[{"name":"Pediatrics Unit Instituto Nacional de Salud del Ni\u00f1o\u00a0\u2013 San Borja San Borja Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9138-8992","authenticated-orcid":false,"given":"Wilmer","family":"C\u00f3rdova\u2010Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Asthma 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