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Diagnostic drug challenges with the lactose-containing preparation (Solu-Medrol 40?mg, Pfizer) were considered unethical due to the recent history of severe systemic reaction and were not performed. By employing a highly sensitive ELISA assay (Veratox Total Milk Elisa kit; Neogen, St. Joseph, MI, USA, limit of detection = 0.5?ppm), we detected traces of milk proteins, within the range of 2.0�C3.5?ppm, in samples from all five batches tested of the implicated product (Solu-Medrol 40?mg, Pfizer), confirming our hypothesis of milk allergen contamination. Although uncommonly, pharmaceutical lactose, contained as an excipient in corticosteroid preparations may be an iatrogenic cause of anaphylaxis in children [http://www.selleckchem.com/products/dabrafenib-gsk2118436.html selleck chemical] with severe CMA, due to milk protein contamination (3, 4). This is particularly relevant, since patients with severe CMA exhibit increased risk of concurrent asthma or other food allergies (5, 6). In the case of an acute allergic event or an asthma exacerbation, these patients are reasonable candidates for systemic administration of (possibly lactose-containing) methylprednisolone. [http://www.selleckchem.com/products/sch772984.html SCH772984] Given that the concurrent asthma exacerbation may potentially decrease threshold for anaphylaxis, intravenous injection of even minute amounts of cow��s milk protein may be sufficient to elicit a severe reaction, e.g. by further aggravating preexisting bronchospasm. In any case, increased caution is warranted, as there is marked risk of mistaking the allergic reaction for apparent under-responsiveness to medication. This may justify additional administration of the allergen-containing drug, as in the case of one of our patients, especially since product information inserts typically do not caution patients with milk allergy about the rare possibility of an allergic reaction to contained milk proteins. It is of paramount importance that non-lactose containing preparations (Table?1) are exclusively used when treating such patients. ""To cite this article: Ruotsalainen M, Piippo-Savolainen E, Hyv?rinen MK, Korppi M. Adulthood asthma after wheezing in infancy: a questionnaire study at 27?years of age. Allergy 2010; 65: 503�C509. [http://en.wikipedia.org/wiki/Ritonavir Ritonavir] Background:? Wheezing in early childhood is a heterogeneous condition, the long-term prognosis varying from total recovery to chronic asthma. Though short-term outcome has been actively studied, there is lack of data on long-term outcome until adulthood. The aim of the study was to evaluate the prevalence and risk factors of asthma at 26�C29?years of age after early-life wheezing. Methods:? At the median age of 27.3?years (range 26.3�C28.6), a questionnaire was sent to 78 study subjects hospitalized for wheezing at