Oral desensitization to milk: how to choose the starting dose!

Abstract

A renewed interest in oral desensitization as treatment for food allergy has been observed in the last few years. We studied a novel method based on the end point skin prick test procedure to establish the starting dose for oral desensitization in a group of 30 children highly allergic to milk. The results (in terms of reactions to the first dose administered) were compared with a group of 20 children allergic to milk as well. Such control group started to swallow the same dose of 0.015 mg/ml of milk. None reacted to the first dose when administered according to the end point skin prick test. On the other side, ten out of 20 children (50%) from the control group showed mild allergic reactions to the first dose of milk. In conclusion the end point skin prick test procedure results safe and easy to be performed in each single child in order to find out the starting dose for oral desensitization to milk, also by taking into account the individual variability.

Fig. 1

End point skin prick tests results in relation to progressive milk dilutions (*from pure milk to 1/1,000,000 dilution). wheal mean size corresponding to the starting dose administered for oral desensitization (1.42 ± 0.8 mm). wheal mean size corresponding to the first dilution provoking allergic reactions (6.64 ± 4.069 mm).