Publication: Alergia a las proteínas de la leche de vaca en lactantes: tratamiento actual y atención farmacéutica
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2015-06
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Abstract
La alergia a las proteínas de la vaca (APLV) tiene una prevalencia del 3% en lactantes y se sitúa en segundo lugar entre las alergias alimentarias seguidas del huevo; sin embargo, suele remitir en la mayoría de los casos antes de los 5 años. Dada la gravedad de sus síntomas, que pueden incluso causar un shock anafiláctico, y la susceptibilidad propia de ese grupo de edad, es de vital importancia el conocimiento y la educación sobre esta alergia a los familiares y población general, siendo la farmacia comunitaria un punto clave de información y consulta. El tratamiento en lactantes se basa en una dieta de restricción de PLV, y sustitución por leches para situaciones especiales, siendo de primera elección las fórmulas altamente hidrolizadas, seguidas de las leches de soja (en mayores de 6 meses); no obstante, si la alergia no se controla se recurrirá a las fórmulas elementales (monoméricas a base de aminoácidos), que presentan una alergenicidad prácticamente nula. En alergias persistentes, se plantea la desensibilización por medio de la inmunoterapia oral, con una elevada tasa de éxito para lograr la tolerancia parcial o total. Este trabajo se enfoca a profundizar en el conocimiento y manejo de esta alergia, con intención de saber dar información completa y detallada desde la farmacia comunitaria.
Allergies to cow’s milk proteins (CMPA) have a prevalence of 3% in infants and are situated in second position among food allergies followed by allergies to eggs; however, CMPA usually subsides in most cases before the age of 5. Because of the severity of the symptoms, which can even cause an anaphylactic shock, and selfsusceptibility in this age group, it is vital to educate about this allergy to relatives and general population, where community pharmacies are a key of information and consultation. The treatment for infants is based on a restricted diet on cow’s milk proteins, and their replacement by special situation’s milks, being the first choice highly hydrolyzed formulas, followed by soya milk (for older than 6 months); however, if allergy is not controlled it could be resorted with elemental formulas (aminoacid base monomer), which has virtually no allergenicity. In persistent allergy, desensibilization arises through oral immunotherapy, with a high rate of success in achieving partial or total tolerance. This work focuses on deeper understanding and management of this allergy, intending to know how to give complete and detailed information in a community pharmacy.
Allergies to cow’s milk proteins (CMPA) have a prevalence of 3% in infants and are situated in second position among food allergies followed by allergies to eggs; however, CMPA usually subsides in most cases before the age of 5. Because of the severity of the symptoms, which can even cause an anaphylactic shock, and selfsusceptibility in this age group, it is vital to educate about this allergy to relatives and general population, where community pharmacies are a key of information and consultation. The treatment for infants is based on a restricted diet on cow’s milk proteins, and their replacement by special situation’s milks, being the first choice highly hydrolyzed formulas, followed by soya milk (for older than 6 months); however, if allergy is not controlled it could be resorted with elemental formulas (aminoacid base monomer), which has virtually no allergenicity. In persistent allergy, desensibilization arises through oral immunotherapy, with a high rate of success in achieving partial or total tolerance. This work focuses on deeper understanding and management of this allergy, intending to know how to give complete and detailed information in a community pharmacy.