Original paper
Therapeutic and nutritional applications of amino acid-based elemental formulas in children with food allergies: a preliminary report

Introduction: Amino acid-based elemental formulas (AAFs) are used for the treatment and nutrition of children with food allergies who show no clinical improvement when fed with extensively hydrolyzed casein-whey protein formulas (eHF) or who develop allergic reaction to these formulas.

Aim: To assess the therapeutic efficacy of amino acid-based elemental formulas in children with severe multiple food allergy (MFA).

Material and methods: The study group consisted of 67 children aged 3 months to 5 years, with a severe clinical course of atopic dermatitis, gastrointestinal or multiple organ symptoms of food allergy. These children had been given eHF without therapeutic effects and developed an allergic response to these formulas. Patients were qualified for treatment of AAF based on an analysis of their diet, the clinical symptoms, individual and family history

of allergy, asIgE specific for cow’s milk proteins class 2 (> 0.7 kU/l). The efficacy of dietary treatment assessed during check-ups was based on a subjective and objective examination, assessment of anthropometric parameters (body mass, height, and SCORAD index score in children with atopic dermatitis). Therapeutic efficacy and tolerance of AAFs were evaluated based on a 4-point scale: from grade 1 – complete recovery to grade 4 – no improvement.

Results: A satisfactory improvement of the clinical state was observed in 60 patients (90%). The best therapeutic effect was in children with multiple organ manifestation of a disease or atopic dermatitis – improvement in 14 (93%) and 33 children (91%), respectively. Three patients (4.5%) did not tolerate the taste of the formula, 2 (3%) had adverse reactions associated with the skin and GI tract.

Conclusions: The AAF had excellent therapeutic and nutritional efficacy in children with severe food allergy. Symptoms of AAF intolerance were only reported occasionally.