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KMID : 1038820230260010043
Pediatric Gastroenterology, Hepatology & Nutrition
2023 Volume.26 No. 1 p.43 ~ p.49
Fecal Calprotectin and Cow¡¯s Milk-Related-Symptoms Score in Children with Cow¡¯s Milk Protein Allergy
Zain-Alabedeen Sahar

Kamel Noha
Amin Mona
Vernon-Roberts Angharad
Day Andrew S.
Khashana Abdelmoneim
Abstract
Purpose: The cow¡¯s milk-related-symptom-score (CoMiSS) tool was developed as an awareness tool for the assessment of cow¡¯s milk-related symptoms in infants or children. Fecal calprotectin (FC) is a noninvasive biomarker of gut inflammation that can be measured in serum and stool. This study aimed to investigate the relationship between FC levels and CoMiSS scores in infants with cow¡¯s milk protein allergy.

Methods: Infants (aged 6?12 months) who were allergic to cow¡¯s milk protein were enrolled prospectively. Following completion of the CoMiSS scoring, the infants were divided into group 1 (positive CoMiSS scores ¡Ã12) and group 2 (negative CoMiSS scores <12). FC was measured using immunoassay.

Results: Of the 120 infants enrolled in this study, 60 (50.0%) had positive CoMiSS scores (group 1), while 60 (50.0%) had negative scores (group 2). The mean FC level was higher in the infants in group 1 than those in group 2 (2,934.57 ¥ìg/g vs. 955.13 ¥ìg/g; p<0.001). In addition, there was a positive correlation between FC and CoMiSS scores (R=0.168, p<0.0001). A FC level of 1,700 ¥ìg/g provided a sensitivity of 98.3%, specificity of 93.3%, and accuracy of 95.8% for the diagnosis of cow¡¯s milk protein allergy (CMPA).

Conclusion: FC measurement may have a role in the assessing infants with CMPA.
KEYWORD
The cow¡¯s milk-related symptom score, Calprotectin, Cow milk protein allergy
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