320 Slov Pediatr 2018; 25
THE INCIDENCE OF ATOPIC MARCH IN CHILDREN WITH  
ALLERGIES TO COW‘S MILK PROTEINS
B. 	 Ivelja
1
,	 V . 	Djurišić
2
, 	 T . 	 Filipović
2
,	S. 	Zejnilović
2
(1) Health Center Cetinje, Cetinje, Montenegro
(2) Institut for Children‘s Diseases KBC Podgorica, Podgorica, Montenegro
ABSTRACT
Introduction: In	 children 	 with	 food	 aller gy	 and 	 atopic 	 dermatitis 	 (AD)	 during 	 the 	 first 	 year	 of 	 life, 	 at 	 a	 later 	
age, 	 asthma 	 and 	 aller gic 	 rhinitis 	 (AR) 	 can 	 develop. 	 The 	 common 	 name 	 for 	 the 	 progression 	 of 	 aller gic	 dis -
eases 	is 	 the 	aller gic	or 	atopic 	march.
Aim: 	 we 	 aimed	 to 	 evaluate 	 whether 	 an 	 aller gy 	 to 	 cow‘s 	 milk 	 proteins 	 (APKM) 	 causes 	 the 	 atopic 	 march 	 and 	
at	 what 	 is	its	 incidence.
Materials and methods: The	 incidence 	 of 	 AD, 	 asthma 	 and 	 AR	 was 	 followed 	 in	 23 	 children 	 with	 APKM.
The 	 criteria 	 used 	 for 	 the 	 diagnosis 	 of 	 atopic 	 march 	 were 	 the 	 medical 	 history 	 (both 	 personal 	 and 	 family), 	 the 	
clinical 	 picture, 	 the 	 total 	 IgE 	 in 	 the 	 blood,	 prick 	 tests	 for 	 nutritional 	 and 	 inhalation 	 aller gens	 and 	 spirometry .
Results: 	 39% 	 of 	 children 	 with 	 APKM 	 (M 	 / 	 F: 	 67% 	 / 	 33%) 	 manifested 	 symptoms 	 of 	 atopic 	 march 	 at 	 the 	 latest 	
by 	 the 	 end 	 of 	 the 	 second 	 year 	 of 	 life. 	 A 	 positive 	 prick 	 test 	 for 	 nutritional 	 and 	 inhalant	 aller gens 	 was	 found	
in 	 60% 	 and 	 in 	 40% 	 for 	 inhalatory 	 aller gens	 only .	 Spirometry 	 results 	 indicated 	 obstruction 	 of 	 the 	 small 	 and 	
medium 	 sized 	 airways 	 in	 all 	 respondents. 	 Appropriately 	 conducted 	 diet 	 without	 PMC	 (lactation	 and	 /	 or 	
milk-based 	 formula 	 extensive 	 hydrolysate) 	 was 	 found 	 in 	 45% 	 of 	 patients. 	 In 	 all 	 subjects 	 a 	 postive 	 family 	
history 	 for 	 aller gies	 was	 detrmined. 	 In	 40% 	 of 	 children,	 APKM	 was 	 maintained 	 for 	 up 	 to 	 2 	 years. 	 T ogether 	
with 	the 	presence	of	 atopy 	 in	the 	family	a	 severe 	clinical 	picture	of	an 	atopic 	march	was	diagnosed.
Conclusion: 	 Infants 	 with 	 APKM 	 are 	 at 	 an	 increased 	 risk 	 for	 atopic 	 march	 exposure.	 Early 	 diagnosis 	 of 	
APKM 	 and 	 an	elimination	diet	 are 	 the	 basis 	 for	 the	prevention	and	treatment	 of 	 atopic 	march.
Key words: allergy, proteins, cow’s milk, atopic march.