{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:39:47Z","timestamp":1790923187620,"version":"4.1.0"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,8,1]]},"abstract":"<jats:p>Objective. Adverse reactions following the ingestion of lactose have been reported in children with cow\u2019s milk (CM) allergy. Whether this is attributable to the contamination of lactose with CM proteins is unknown. In this paper, we assessed clinical tolerance of lactose derived from CM whey in children hypersensitive to CM from 2 university hospital pediatric departments.<\/jats:p>\n               <jats:p>Design. Twenty-four children (5 girls and 19 boys, median 25 months old; range: 2\u2013107 months) with immediate CM allergy confirmed at history or during double-blind, placebo-controlled food challenge (DBPCFC) were enrolled. DBPCFC with CM could be conducted in 11 of 24 patients. Children with a history of immediate\/delayed reactions to soy formula (SF) were excluded. Clinical tolerance to CM, SF, and SF + lactose was assessed by: 1) skin prick test with casein, lactalbumin, soy commercial allergen preparations, fresh CM, SF, SF and lactose, lactose (Official Pharmacopoeia) in 4 concentrations (0.01%, 0.1%, 1%, 10%); 2) specific serum immunoglobulin E determination by CAP system technology; 3) DBPCFC in 8 incremental doses of SF + lactose and using SF as a placebo to make up a total of 240 mL of reconstituted formula.<\/jats:p>\n               <jats:p>Results. With a positive cutoff point of \u22653 mm wheal diameter at SPT, all patients were sensitized to fresh CM, lactalbumin, and\/or casein. Twenty-three of 24 patients (95.8%) were SPT-positive to CM formula, 16 of 24 to lactalbumin (66.6%), 14 of 24 to casein (58.3%), and none to SF, SF + lactose, or lactose alone at all dilutions. Complexed immunoglobulin E determinations were positive for CM in 23 of 24 cases and negative in all cases for soy. Challenge with SF + lactose was negative in all cases.<\/jats:p>\n               <jats:p>Conclusions. Even children hypersensitive to CM are clinically tolerant to lactose and can safely consume foods and drugs with lactose from bovine sources as an ingredient. Lactose exclusion is unwarranted from soy preparations on grounds of potential allergic reactions to CM protein residue.<\/jats:p>","DOI":"10.1542\/peds.112.2.359","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"359-362","source":"Crossref","is-referenced-by-count":42,"title":["Clinical Tolerance to Lactose in Children With Cow\u2019s Milk Allergy"],"prefix":"10.1542","volume":"112","author":[{"given":"Alessandro","family":"Fiocchi","sequence":"first","affiliation":[{"name":"Department of Child and Maternal Medicine, Melloni Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Restani","sequence":"additional","affiliation":[{"name":"Department of Pharmacological Sciences University of Milan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gualtiero","family":"Leo","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Buzzi Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Martelli","sequence":"additional","affiliation":[{"name":"Department of Child and Maternal Medicine, Melloni Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel R.","family":"Bouygue","sequence":"additional","affiliation":[{"name":"Department of Child and Maternal Medicine, Melloni Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Terracciano","sequence":"additional","affiliation":[{"name":"Department of Child and Maternal Medicine, Melloni Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ballabio","sequence":"additional","affiliation":[{"name":"Department of Pharmacological Sciences University of Milan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Valsasina","sequence":"additional","affiliation":[{"name":"Centro Studi Humana, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,8,1]]},"reference":[{"key":"2021121003353442100_R1","unstructured":"Barnes Koerner C, Sampson HA. Diets and nutrition. In: Metcalfe DD, Sampson HA, Simon RA, eds. Food Allergy: Adverse Reactions to Foods and Food Additives. Cambridge, MA: Blackwell Science; 1991:332\u2013354"},{"key":"2021121003353442100_R2","doi-asserted-by":"crossref","unstructured":"Taylor SL, Hefle SL. Ingredient and labeling issues associated with allergenic foods. Allergy.2001;56(suppl 67):S64\u2013S69","DOI":"10.1034\/j.1398-9995.2001.00920.x"},{"key":"2021121003353442100_R3","unstructured":"Comite\u0301 de Nutrition de la Socie\u0301te\u0301 Franc\u0327aise de Pediatrie. Infant formulas and soy protein-based formulas: current data. Arch Pediatr.2001;8:1226\u20131233"},{"key":"2021121003353442100_R4","doi-asserted-by":"crossref","unstructured":"Host A, Koletzko B, Dreborg S, et al. Dietary products used in infants for treatment and prevention of food allergy. 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Evaluation by SDS-PAGE and immunoblotting of residual antigenicity in hydrolysed protein formulas. Clin Exp Allergy.1995;25:131\u2013134","DOI":"10.1111\/j.1365-2222.1995.tb01113.x"},{"key":"2021121003353442100_R9","doi-asserted-by":"crossref","unstructured":"Neuhoff V, Arold N, Taube D, Ehrhrdt W. Improved staining of proteins in polyacrylamide gels including isoelectric focusing gels with clear background at nanogram sensitivity using Coomassie Brilliant Blue G-250 and R-250. Electrophoresis.1988;9:255\u2013262","DOI":"10.1002\/elps.1150090603"},{"key":"2021121003353442100_R10","doi-asserted-by":"crossref","unstructured":"Restani P, Velona T, Plebani A, et al. Evaluation by SDS-PAGE and immunoblotting of residual antigenicity in hydrolysed protein formulas. Clin Exp Allergy.1995;25:651\u2013658","DOI":"10.1111\/j.1365-2222.1995.tb01113.x"},{"key":"2021121003353442100_R11","unstructured":"Bock SA. In vivo diagnosis: skin testing and oral challenge procedures. In: Metcalfe DD, Sampson HA, Simon RA. Food Allergy: Adverse Reactions to Foods and Food Additives. 2nd ed. Cambridge, MA: Blackwell Science; 1997:161"},{"key":"2021121003353442100_R12","unstructured":"Roger A, Rubira N, Nogueiras C, Guspi R, Baltasar M, Cadahia A. Anaphylaxis caused by royal jelly. Allergol Immunopathol (Madr).1995;23:133\u2013135"},{"key":"2021121003353442100_R13","doi-asserted-by":"crossref","unstructured":"Stallings VA. Calcium and bon health in children: a review. 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