Cow's Milk Protein Allergy (CMPA) ; CoMiSS Score and Its Interpretation

The Cow's Milk-related Symptom Score (CoMiSS) is an awareness tool used to evaluate and quantify symptoms that may be suggestive of Cow's Milk Protein Allergy (CMPA). It's important to note that the CoMiSS scoring form is not a diagnostic tool but rather a guide to help clinicians identify and assess the likelihood of CMPA in their patients. The interpretation of the total CoMiSS score is as follows:

1. Total Score < 6:

   • Interpretation: Symptoms are unlikely to be related to CMA. Clinicians should consider other causes for the symptoms.
   • Action: Further investigation for alternative diagnoses is recommended.
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2. Total Score ≥ 10:

   • Interpretation: This score range may suggest cow's milk-related symptoms and could potentially indicate CMPA.
   • Action: It warrants further evaluation, possibly including an elimination diet and an oral food challenge, to confirm the diagnosis.

The CoMiSS evaluates a range of symptoms including skin manifestations (such as worsening of eczema), gastrointestinal symptoms, respiratory symptoms, and others. Specific symptoms, like urticaria or angioedema, which can be directly related to cow's milk consumption (e.g., occurring after drinking milk in the absence of other food), are strongly suggestive of CMA.

Access CoMiss here https://www.nestlehealthscience.co.uk/health-management/paediatrics-food-allergy/cows-milk-protein-allergy/diagnosis/comiss/comiss-score