Fecal calprotectin levels in pediatric cow's milk protein allergy

Dominika Lendvai-Emmert; Vanessza Emmert; Alexandra Makai; Katalin Fusz; Viktória Prémusz; Kata Eklics; Patrícia Sarlós; Péter Tóth; Krisztina Amrein; Gergely Tóth

doi:10.3389/fped.2022.945212

Fecal calprotectin levels in pediatric cow's milk protein allergy

Front Pediatr. 2022 Aug 9:10:945212. doi: 10.3389/fped.2022.945212. eCollection 2022.

Authors

Dominika Lendvai-Emmert^{1

2

3}, Vanessza Emmert^{1

4}, Alexandra Makai^{1

5}, Katalin Fusz⁶, Viktória Prémusz^{1

5}, Kata Eklics⁷, Patrícia Sarlós⁸, Péter Tóth^{2

3}, Krisztina Amrein^{2

3}, Gergely Tóth^{1

4}

Affiliations

¹ Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
² Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary.
³ Neurotrauma Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
⁴ Erzsébet Teaching Hospital and Rehabilitation Institute, Sopron, Hungary.
⁵ Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
⁶ Department of Physiology, Medical School, University of Pécs, Pécs, Hungary.
⁷ Department of Languages for Biomedical Purposes, University of Pécs, Pécs, Hungary.
⁸ First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary.

Abstract

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.

Keywords: Gastroenterology; children; cow's milk protein allergy; dairy; elimination diet; fecal calprotectin; food allergy.