Standardised guidelines for management of cow's milk allergy

The World Allergy Organization (WAO) Food Allergy Special Committee's Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines were published in the April 2010 issue of the WAO Journal. The consensus-based approach to the development of these guidelines was presented at a meeting on Adverse Reactions to Bovine Proteins in Italy in early 2010. A summary report of the workshop has recently been published and is freely available for download.

Under the two banners of basic science and clinical science, the report details several aspects of cow's milk allergy. Topics discussed under the basic science heading include the different allergenic proteins in cow's milk, epidemiology and prevalence of allergy to these proteins, and pathogenesis of cow's milk allergy. The clinical science section deals with immediate and delayed reactions and includes a table listing the extensive clinical manifestations of cow's milk allergy plus a listing of some more unusual presentations of the allergy.

A useful summary is provided on page six of the 22 page document, in a boxed section entitled 'What DRACMA brings to the treatment of cow's milk allergy'.

DRACMA aims to provide leadership in the area of management of cow’s milk allergy by coordinating the multidisciplinary approaches employed to tackle the problem of cow's milk allergy world-wide, and by implementing consensus-based clinical practice guidelines to disseminate the body of knowledge, including foreseeable breakthroughs.

Reference: Fiocchi et al. 2010. Journal of Allergy and Clinical Immunology. Vol.126(6) pp.1119-1128.e12.