Milk and cow’s meat allergy in a child: A clinical case

Allergy to bovine serum albumin is the main predictor of beef allergy associated with cow’s milk proteins allergy. We report a case of a 3-year-old child with cow’s milk proteins allergy since the age of 6 months who, after some ingestions of beef, de-veloped episodes of irritability, urticaria and syncope. Specific IgE to beef, oral food challenge with medium rare cooked beef and specific IgE to bovine serum albumin were all positive, but an oral food challenge with well cooked beef was tolerated. Allergy to bovine serum albumin is not usually associated with severe reactions, since it is a thermolabile protein, however, the process of cooking meat may be insufficient to have an effect on the complex matrix of meat and associated serum albumins. The irregular pattern of the episodes and the previous diagnosis of cow’s milk proteins allergy may act as confounding factors leading to a delayed diagnosis.