İnek Sütü Alerjisine Güncel Yaklaşım

İnek sütü alerjisi infantlarda ve çocukluk çağında en sık görülen besin alerjilerindendir ve sıklığı farklı çalışmalarda %1.8-7.5 olarak bildirilmektedir. Hastaların %80’inde 6 yaşında tolerans bildirilmektedir. İnek sütü alerjisi inek süt proteinlerinin (β-laktoglobulin, kazein v.b) herhangi birine karşı oluşan anormal immünolojik yanıt sonucu gelişen advers reaksiyon olarak tanımlanır. Klinik olarak, %60 gastrointestinal sistem, %50-60 deri ve mukoza tutulumu ve %9 anafilaksi tablosu görülür. İnek sütü alerjisi tanısında tanıyı doğru koymak için klinik ve laboratuar bulguları birlikte değerlendirmek önemlidir. Tanıda yardımcı laboratuar tetkikleri alerjen duyarlılaşmaya gösteren süt spesifik IgE ölçümü ve deri testleri (prik ve atopi yama testi), altın standart olarak ise oral besin yükleme testidir. Klasik tedavide inek sütü proteinlerini içeren gıdaları içermeyen eliminasyon diyeti tolerans gelişinceye kadar verilir. Kazara alımlara bağlı anafilaksi gibi ölümcül reaksiyonlar gelişebilmesi riski nedeniyle, hasta ve ebeveynleri inek süt proteini içeren gıdalar ve alternatif besin kaynakları konusunda bilgilendirilmeli; kişiye göre risk analizi ve acil durum planı ile yapılmalıdır. Eliminasyon diyeti ile izlenen hastalar düzenli aralıklarla tolerans gelişimi açısından değerlendirilmelidir. Bununla birlikte, oral immünoterapi günümüzde IgE aracılı persistan İSA tanısı olan 4-5 yaşları arasındaki hastalarda sadece deneyimli merkezlerde yapılabilen bir tedavi seçeneğidir.

Anahtar Kelimeler:

inek sütü alerjisi, tanı, tedavi

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