“FREQUENCY OF FATAL AND RECURRENT ANAPHYLAXIS DUE TO COW’S MILK: A
SYSTEMATIC REVIEW AND META-ANALYSIS OF OBSERVATIONAL STUDIES”.
Background: Cow’s milk allergy can result in anaphylactic reactions. The
estimated prevalence of cow’s milk allergy in developed countries ranges
from 0.5% to 3% at age 1 year. Objective: Our objective was to perform
a systematic review and, if possible, a meta-analysis to assess the
frequency of fatal and recurrent anaphylaxis induced by cow’s milk.
Methods: We searched PubMed/MEDLINE, EMBASE, and the Web of Science for
studies that had assessed fatal and recurrent anaphylaxis induced by
cow’s milk for the population of a country or at least an administrative
region. Our review included cohort, cross-sectional, and registry
studies that had assessed the incidence or prevalence of recurrent
anaphylaxis or the incidence of fatal anaphylaxis due to cow’s milk.
Results: The pooled prevalence of recurrence (PR) for at least an
episode of anaphylaxis was 26.98% (3.41-155.19). Teymourpour et al
(Iran) reported the highest PR (53.10%); the 2 studies with the lowest
PR were from France (5.16 and 0.42 respectively) (p<0.01).
Nine studies on fatal anaphylaxis were selected (41 deaths) and found to
be highly heterogeneous (I 2=75.91%). Levy et al and
Bassagio et al reported the highest incidence rate (IR 0.15 and 0.6
deaths per million persons-year). Conclusion: The PR of anaphylaxis was
approximately one quarter of patients with anaphylaxis due to cow’s
milk, while deaths from anaphylaxis caused by cow’s milk were very rare,
although some studies report rates as high as 15 times the lowest IR.