الفهرس 
Food allergyOnly 14 pages are availabe for public view
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Abstract
Food allergy rates have a wide range of variability by age, diet, and many other factors, however eight types of food account for more than 90% of allergic reactions in affected individuals: milk, eggs, fish, tree nuts, peanuts, soy, shellfish, and wheat.
Cow’s milk allergy (CMA) is the abnormal response to proteins found in cow milk or its products. The reported prevalence of CMA is less than 5.0%, and according to the EuroPrevall data, the prevalence of CMA is even as low as 0.54%. Cow’s milk has more than 20 protein fractions, the most significant allergens are casein protein which includes alpha-s1, alpha-s2, beta and kappa casein, also whey proteins which include alpha-lactalbumin and beta-lactoglobulin.
CMA reactions have an immunological base and are classified into IgE mediated, non-IgE mediated and mixed types. Some symptoms of CMA, such as problems in bowel habits, regurgitation and colic are common in functional GI disorders of infants, in addition there is no gold-standard diagnostic test for CMA and the diagnosis depends on an Open Food Challenge (OFC) test, so differentiation between functional GI disorders and CMA in infants presenting with these overlapping symptoms is usually difficult.
So, developing an awareness tool was essential to recognize symptoms that are related to CMA in infants to help in increasing awareness and recognition of these symptoms. This occurred in September 2014 in Brussels, Belgium with the development of Cow’s Milk-related Symptom Score (CoMiSS) to help in the identification of infants suspected to have CMA, particularly those with non-IgE mediated types. Crying, regurgitation, stool pattern, skin and respiratory symptoms were the domains defined for the CoMiSS score, and a cut-off point of 12 was recommended in this consensus as a potential score to indicate CMA. Despite being a clinically useful tool in identifying infants with CMA, CoMiSS cannot be used as a cornerstone for diagnosis of infants with obvious CMA such as those with anaphylactic or immediate IgE-mediated reactions who will not be picked up by the CoMiSS, but it may be used as a helpful tool to identify infants with persisting GI symptoms who may benefit from Cow Milk Free Diet (CMFD) when the diagnosis of CMA is suspected.