Caracterização clínica e epidemiológica de crianças sul-americanas diagnosticadas com alergia à proteína do leite de vaca: Uma revisão sistemática

Autores

DOI:

https://doi.org/10.33448/rsd-v14i11.49843

Palavras-chave:

Alergia à proteína do leite de vaca, Alergia alimentar, Atenção Primária à Saúde, Epidemiologia.

Resumo

Introdução: A Alergia à Proteína do Leite de Vaca (APLV) é uma das alergias alimentares mais prevalentes na infância, apresentando múltiplas manifestações clínicas e diferentes formas de mediação imunológica, o que dificulta seu diagnóstico, sobretudo na Atenção Primária à Saúde. No Brasil, a escassez de dados epidemiológicos sobre APLV dificulta a elaboração de políticas públicas e estratégias eficazes de rastreio. Objetivo: O principal objetivo foi reunir e sintetizar dados disponíveis sobre a caracterização clínica e epidemiológica da alergia à proteína do leite de vaca. Metodologia: Trata-se de uma revisão sistemática, que teve como parâmetro o protocolo PRISMA e bases de dados. Foram incluídos estudos clínicos, comunitários, observacionais, coorte e transversais em crianças com 0 aos 23 meses e 29 dias residentes do Brasil.  Resultados: A busca resultou em 5.044 registros, dos quais 4.564 foram triados após a remoção de duplicatas. Observou-se predomínio do sexo masculino (59,7%), e de manifestações gastrointestinais na apresentação clínica. O teste de provocação oral foi raramente aplicado, evidenciando limitações diagnósticas regionais. Esses achados caracterizam o perfil clínico e nutricional da APLV em lactentes latino-americanos. Conclusão: A revisão evidenciou que a APLV em lactentes latino-americanos é predominantemente não IgE-mediada, com produção científica concentrada no Brasil e desafios diagnósticos marcados pela baixa aplicação do Teste de Provocação Oral. A terapêutica com fórmulas extensamente hidrolisadas mostrou-se essencial, e a associação com distúrbios neuropsiquiátricos indica a necessidade de integrar o rastreio psicossocial ao manejo pediátrico.

Referências

Assis, P. P. et al. (2022). Growth of infants with gastrointestinal manifestations of cow’s milk protein allergy. Revista de Nutrição. 35.

Berni Canani, R. et al. (2024). Skin, gut, and lung barrier: Physiological interface and target of intervention for preventing and treating allergic diseases. Allergy. 79(6), 1485–500. https://doi.org/10.1111/all.16092.

Brozek, J. L. et al. (2022). World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guideline update – XIV – Recommendations on CMA immunotherapy. World Allergy Organization Journal. 15(4). https://doi.org/10.1016/j.waojou.2022.100646.

Calle, C. G. et al. (2024). Clinical characteristics, laboratory findings, and tolerance acquisition in infants with cow’s milk protein allergy in a private center in Lima, Peru for the period 2021–2022. Immunity, Inflammation and Disease. 12(4), e1246. https://doi.org/10.1002/iid3.1246.

Cruchet, S. et al. (2025). Prevalence of Cow’s Milk Allergy in Infants from an Urban, Low-Income Population in Chile: A Cohort Study. Nutrients. 17(11). https://www.mdpi.com/2072-6643/17/11/1859.

Doğruel, D. et al. (2016). Clinical Features of Food Allergy during the 1st Year of Life: The ADAPAR Birth Cohort Study. International Archives of Allergy and Immunology. 169(3), 171–80. https://doi.org/10.1159/000444639.

Dupont, C. et al. (2016). Tolerance and growth in children with cow’s milk allergy fed a thickened extensively hydrolyzed casein-based formula. BMC Pediatrics. 16(1), 96. https://doi.org/10.1186/s12887-016-0637-3.

Faria, D. et al. (2023). Real-life data on the effectiveness of extensively hydrolyzed protein-based formula and amino acid–based formula in regaining weight and height in infants on a cow’s milk protein elimination diet. Allergologia et Immunopathologia. 51, 177–83.

Fong, A. T. et al. (2022). The Economic Burden of Food Allergy: What We Know and What We Need to Learn. Current Treatment Options in Allergy. 9(3), 169–86. https://doi.org/10.1007/s40521-022-00306-5.

Frizzo, J. et al. (2022). Evaluation of the complementary feeding practices, dietary intake, and nutritional status of infants on a cow’s milk protein elimination diet. Jornal de Pediatria. 98(3), 256–63. https://www.sciencedirect.com/science/article/pii/S0021755721000991.

Hao, L., Wang, S. & Ji, W. (2025). Cow’s milk protein allergy: A comprehensive review of epidemiology, pathogenesis, clinical manifestations, diagnostics, and management strategies. Asia Pacific Journal of Clinical Nutrition. 34(3), 298–307. https://doi.org/10.6133%2fapjcn.202506_34(3).0004.

Hendricx, F. et al. (2024). Regional differences in diagnosis and management of cow’s milk allergy. Clin Exp Pediatr. 67(11), 601–7. https://doi.org/10.3345/cep.2023.01550.

Lockwood, C. et al. (2017). Systematic reviews of qualitative evidence. Joanna Briggs Institute reviewer’s manual [Internet]. Adelaide: The Joanna Briggs Institute.

Martins, T. G. et al. (2024). Factors Associated with Weaning in Infants with Cow’s Milk Allergy: A Cohort Study. Breastfeeding Medicine. 20(1), 65–72. https://doi.org/10.1089/bfm.2024.0108.

Maslin, K. et al. (2016). Dietary variety and food group consumption in children consuming a cows’ milk exclusion diet. Pediatric Allergy and Immunology. 27(5), 471–7. https://doi.org/10.1111/pai.12573.

Mehaudy, R. et al. (2022). Cow’s milk protein allergy; new knowledge from a multidisciplinary perspective. Archivos argentinos de pediatria. 120(3), 200–6. http://europepmc.org/abstract/MED/35533123.

Montero Verdecia, D. E. et al. (2024). Caracterización clínica y epidemiológica de pacientes con alergia a las proteínas de la leche de vaca. Multimed. 28.

Nocerino, R. et al. (2025). The Burden of Cow’s Milk Protein Allergy in the Pediatric Age: A Systematic Review of Costs and Challenges. Healthcare. 13(8). https://www.mdpi.com/2227-9032/13/8/888.

Oliveros, L. V. et al. (2024). Managing cow’s milk protein allergy during the 2022 formula shortage: decision-making among pediatric healthcare providers. Frontiers in Allergy. vol. 5. https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2024.1359103.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [e-book]. Ed. UAB/NTE/UFSM.

Ramsey, N. & Berin, M. C. (2021). Pathogenesis of IgE-mediated food allergy and implications for future immunotherapeutics. Pediatric Allergy and Immunology. 32(7), 1416–25. https://doi.org/10.1111/pai.13501.

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 104, 333-9. https://doi.org/10.1016/j.jbusres.2019.07.039.

Suratannon, N. et al. (2023). Cost-effectiveness of therapeutic infant formulas for cow’s milk protein allergy management. Frontiers in Nutrition. vol. 10-2023. https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1099462.

Topal, E et al. (2016). Psychiatric disorders and symptoms severity in pre-school children with cow’s milk allergy. Allergol Immunopathol (Madr). 44(5):445-9. doi: 10.1016/j.aller.2016.03.001.

Ullberg, J., Fech-Bormann, M. & Fagerberg, U. L. (2021). Clinical presentation and management of food protein-induced enterocolitis syndrome in 113 Swedish children. Allergy. 76(7), 2115–22. https://doi.org/10.1111/all.14784.

Vasconcelos, P. S. P. et al. (2024). Outcomes and factors associated with tolerance in infants with non-IgE-mediated cow’s milk allergy with gastrointestinal manifestations. Jornal de Pediatria. 100(1), 40–5. https://www.sciencedirect.com/science/article/pii/S0021755723001006.

Yang, M. et al. (2019). Prevalence, Characteristics, and Outcome of Cow’s Milk Protein Allergy in Chinese Infants: A Population-Based Survey. Journal of Parenteral and Enteral Nutrition. 43(6), 803–8. https://doi.org/10.1002/jpen.1472.

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Publicado

2025-11-15

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Ciências da Saúde

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Caracterização clínica e epidemiológica de crianças sul-americanas diagnosticadas com alergia à proteína do leite de vaca: Uma revisão sistemática. Research, Society and Development, [S. l.], v. 14, n. 11, p. e113141149843, 2025. DOI: 10.33448/rsd-v14i11.49843. Disponível em: https://www.rsdjournal.org/rsd/article/view/49843. Acesso em: 5 dez. 2025.