Clinical Presentation of CMPA

Breaking down
the two types.

The main difference between the two types of CMPA is the presence of antibodies. In IgE-mediated CMPA antibodies are present, whereas with non-IgE-mediated CMPA the immune system does not produce antibodies.

IgE-mediated CMPA

With IgE-mediated cow’s milk allergy, symptoms are usually visible within minutes or up to 2 hours after ingestion and can range from mild to severe.

The presence of these IgE antibodies means that cytokines and hystamines are released, which in turn trigger an inflammatory response. That’s why symptoms associated with IgE-mediated CMPA are generally related to inflammation – itching, swelling, gastrointestinal problems like tummy pain and diarrhea, hay fever and difficulties breathing.

Non-IgE-mediated CMPA

Non-IgE-mediated CMPA is often recognisable because the symptoms take a lot longer to appear after ingestion. Research indicates that the reaction is mediated by the T cells of the immune system, but this mechanism is still not very well understood.

The delayed symptoms that occur with non-IgE-mediated CMPA are easier to confuse with other causes not related to cow’s milk protein. They include colic-type symptoms, skin symptoms like eczema and itching, reflux and a different range of gastrointestinal symptoms (unusual stools, tummy pain and constipation).

Mixed allergic reaction

Some babies can have mixed allergic reactions, with symptoms of both IgE-mediated and non-IgE-mediated allergy. This means that they will have a mix of symptoms, some of which come on quickly while others take a few days to appear.