Intolerância à lactose e alergia à proteína do leite: uma revisão.

Abstract

Allergy and food intolerance are represented by adverse reactions to any food or food additive. The prevalence of allergic diseases has increased in recent decades and the food allergy is a major factor responsible for this increase. The main difference between allergy and intoleranceis milk allergy involves immune mechanisms against milk proteins (casein, alpha-lactalbumin, betalactoglobulin) while milk intolerance is caused by enzymatic deficiency that not allowed lactose digestion. Diagnosis of these both pathologies must be cautiously performed; the treatment is based on milk elimination diet, although it is an important nutrient source. This study aimed to report differences between Cow Milk Protein Allergy (CMPA) and Lactose Intolerance (LI), their main causes and consequences in order to better understand their disorders, diagnoses and treatments. A systematic literature review of the last 10 years was performed, included surveys of original and review articles, editorials and guidelines in Medline, Pubmed, Lilacs and Scielo data bases; also national and international health committees that discussed CMPA and LI. All information in English and Portuguese was considered. 56 articles found on the topic, which 48 articles, 3 theses and dissertations 4 were used to carry out this work. It was concluded that CMPA is completely related to immune responses while LI is a metabolic disorder caused by an enzyme deficiency. There are several methods for CMPA diagnosis and TPO the most usual. On the other hand, The LI is detected by glycemic index or expired hydrogen test. The CMPA treatment is basically and elimination diet, while in the LI this exclusion is partial. Despite of the pathology, a diagnostic error will have consequences on nutritional, physical and psychological status of the patient.