Predictors of a positive oral food challenge to cow's milk in children sensitized to cow's milk
| Autor: | O. Asensio-De la Cruz, M. Bosque-García, M. García-González, H. Larramona-Carrera, R. Ayats-Vidal, L. Valdesoiro-Navarrete |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Adolescent Immunology Administration Oral Milk allergy Immunoglobulin E 03 medical and health sciences 0302 clinical medicine Food allergy Reference Values Internal medicine mental disorders medicine Immunology and Allergy Animals Humans In patient Child Retrospective Studies biology Receiver operating characteristic Oral food challenge business.industry food and beverages Infant Wheal Size General Medicine Gold standard (test) Allergens medicine.disease Milk Proteins 030228 respiratory system ROC Curve Child Preschool biology.protein Cattle Female Milk Hypersensitivity business psychological phenomena and processes 030215 immunology |
| Zdroj: | Allergologia et immunopathologia. 48(6) |
| ISSN: | 1578-1267 |
| Popis: | The diagnosis of IgE-mediated cow's milk allergy (CMA) is often based on clinical history and on specific IgE levels and/or skin-prick tests (SPT), both of which are sensitive but not specific. The gold standard, oral food challenge (OFC), is expensive and time-consuming and involves a risk of severe allergic reactions. This study aimed to determine the value of specific IgEs, ratios of specific IgEs for cow's milk and its components to total IgE, and wheal size on SPT for predicting a positive OFC for CMA.We retrospectively studied 72 patients [median age, four years; age range 0.75-15 years] sensitized to cow's milk who underwent OFCs to milk. predictive variables between patients with positive and negative OFCs were compared. Receiver operator characteristic (ROC) curves were uses to assess variables' discriminatory capacity and Youden's index to determine the best cut-offs for predicting CMA.The OFC was positive in 39 (54%) patients. Wheal size on SPT and all specific IgEs and specific-to-total IgE ratios were significantly different between patients with positive OFCs and those with negative OFCs (p0.001). The variable with the greatest area under the ROC curve was casein-specific IgE (0.98), followed by β-lactoglobulin-specific IgE (0.923), casein-specific-to-total-IgE ratio (0.919), and α-lactalbumin-specific IgE (0.908). Casein-specific IgE ≥0.95kU/L yielded 88.9% sensitivity and 90.9% specificity.In our center, casein-specific IgE0.95kU/L can obviate an OFC to cow's milk for the diagnosis of CMA in patients sensitized to cow's milk with a compatible history. |
| Databáze: | OpenAIRE |
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