İnek Sütü Alerjisine Güncel Yaklaşım

Year 2019, Volume: 7 Issue: 2, 146 - 155, 27.08.2019

Nurşen Ciğerci Günaydın

Abstract

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. 

Keywords

inek sütü alerjisi, tanı, tedavi

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