Cow Milk Protein Allergy
Conditions
Keywords
Zinc, Cow Milk Protein Allergy, COMISS, SCORAD
Brief summary
Children presented with manifestations of Cow Milk Protein Allergy will be enrolled for Cow Milk -related Symptoms Score (CoMiSS assessment). Detailed History, nutritional and clinical examination will be done to fulfill items of CoMiSS. Children will be randomly allocated to two groups. Oral Zinc will be supplemented to the interventional group. CoMiSS will be recorded at the baseline and weekly till 4 weeks. Then Oral Food Challenge (OFC) will be done to confirm the diagnosis and CoMiSS assessment will be recorded again to see if Zinc has any modulatory effect on reappearance of symptoms. The people administering the intervention, the people assessing the outcomes, the patients and their caregivers will all be blinded to the type of treatment. Children who will be presented with skin manifestation will be assessed by Severity Scoring of Atopic Dermatitis Index (SCORAD score) once diagnosed and weekly till 4 weeks after zinc supplementation to see if Zinc has any modulatory effect.
Detailed description
Children who will be presented with manifestations of Cow Milk Protein Allergy will be enrolled in the study for Cow Milk -related Symptoms Score (CoMiSS) assessment. Detailed History, nutritional and clinical examination will be done to fulfill items of CoMiSS including skin manifestations as eczema , respiratory manifestations, GIT manifestations as constipation or diarrhea including Bristol scale and regurgitations and duration of crying . Children will be randomly allocated to two groups. Randomization will be done using GraphPad QuickCalcs software to allocate into either the interventional or control group. Oral Zinc will be supplemented to the interventional group on adose of 30 mg elemental zinc/day. CoMiSS will be recorded at the baseline and weekly till 4 weeks. Then Oral Food Challenge (OFC) will be done to confirm the diagnosis and CoMiSS assessment will be recorded againto see if Zinc has any modulatory effect on reappearance of symptoms. The people administering the intervention, the people assessing the outcomes, the patients and their caregivers will all be blinded to the type of treatment. Children who will be presented with skin manifestation will be assessed by Severity Scoring of Atopic Dermatitis Index (SCORAD score) once diagnosed and weekly till 4 weeks after zinc supplementation to see if Zinc has any modulatory effect.
Interventions
Oral Zinc will be supplemented to the interventional group on a dose of 30 mg elemental zinc/day.
OTHERPlacebo
Oral
Sponsors
Kasr El Aini Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
one group will receive oral Zinc therapy while the other group will recieve placebo
Eligibility
Sex/Gender
ALL
Age
1 Months to 12 Years
Healthy volunteers
No
Inclusion criteria
Children suspected to have Cow Milk Protein Allergy using Cow's Milk-relatedSymptoms Score with a Score more than12 Age less than 12 years old both sexes Whose parents approved to be enrolled in the study
Exclusion criteria
Children with Comorbidities that may affect the duration of treatment as dysphagia. History of Severe allergic reaction that required hospital admission as Ora Food Challenge is expectedto be delayed in these patients. -Multiple Food Allergies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| COMISS(Cow Milk Related symptom Score) | 2 weeks | Evaluate the degree of change in COMISS Sc0re(Cow Milk Related symptom Score) between the interventional group and control group The COMISS Score ranges from 0 to 33. Each symptom has a maximal score of six,exception of respiratory symptoms(maximal score of three). a cut-off value\>12 was selected as the criterion to pick up infant at risk of Cow Milk Allergy . A score of 12 requires the presence of at least two severe symptoms and a score higher than10 requires the precense of at least three symptoms and the involvement of two organ systems |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| COMISS (Cow Milk Related Symptom Score)and SCORAD (Severity Scoring of Atopic Dermatitis index) | 4 Weeks | 1. Degree of change clinicaiiy by SCORAD (Severity Scoring of Atopic Dermatitis index) between the intervention and control group upon Zinc adminstration. SCORAD is a clinical tool used to assess the extent and severity of eczema, To determine extent by is the 'rule of nine': 9% for the head and neck, each arm, the front and back of each leg, the four trunk quadrants, and 1% for the genitalia, The intensity part of the index consists of six items: erythema, oedema/papulation, excoriations, lichenification, oozing/crusts and dryness. Each item can be graded on a scale 0-3 pruritus and sleeplessness (0-10)for each, SCORAD score range is between 0 and 103 points and defines three classes of AD severity (. mild if SCORAD \<25, moderate if 25 ≤ SCORAD ≤ 50 and severe if SCORAD \> 50. 2. The Change in the degree of improvement between the interventional and control group based on COMISS score at 1,2, 3, and 4 weeks. 2.Time to improvement of COMISS score below 12 in both groups. |
Countries
Egypt
Outcome results
None listed