Accuracy of serum IgE concentrations and papule diameter in the diagnosis of cow's milk allergy
Journal Title: Jornal de Pediatria - Year 2018, Vol 94, Issue 3
Abstract
Objective To compare serum concentrations of specific IgE and mean papule diameters induced in the immediate skin reactivity test with cow's milk and its fractions with results of the oral challenge test, and to establish cutoff points capable of predicting clinical reactivity to cow's milk in patients treated at a referral service. Methods One hundred and twenty-two children (median of 17 months) with a history of immediate reactions to cow's milk and presence of specific IgE for cow's milk and/or its fractions (positive skin and/or IgE serum tests) were submitted to open oral challenge test with cow's milk. Results The oral challenge test was positive in 59.8% of the children, 49% of whom were males. Serum levels of specific IgE, as well as mean cow's milk papule diameters, were significantly higher in allergic patients (medians: 3.39kUA/L vs. 1.16kUA/L, 2.5mm vs. 0mm). The optimal cutoff points (Youden's index) of serum IgE specific for cow's milk and its fractions capable of predicting cow's milk reactivity (positive oral challenge test) were: 5.17kUA/L for cow's milk, 0.95kUA/L for α-lactalbumin, 0.82kUA/L for β-lactoglobulin, and 0.72kUA/L for casein, whereas for papule diameters the cutoff points were 3.5mm for cow's milk and 6.5mm, 9.0mm, and 3.0mm for the α-lactalbumin, β-lactoglobulin, and casein fractions, respectively. Conclusions The cutoff points capable of predicting clinical reactivity to cow's milk were: 5.17kUA/L for serum-specific IgE and 3.5mm for papule diameter measurement, values considered discriminatory for the diagnosis of cow's milk allergy.
Authors and Affiliations
Jackeline Franco
Keywords
Related Articles
- EP ID EP485073
- DOI 10.1016/j.jped.2017.06.022
- Views 71
- Downloads 0
Chloride and sodium ion concentrations in saliva and sweat as a method to diagnose cystic fibrosis
Objective Cystic fibrosis diagnosis is dependent on the chloride ion concentration in the sweat test (≥60mEq/mL – recognized as the gold standard indicator for cystic fibrosis diagnosis). Moreover, the salivary glands ex...
Special topics in pediatrics
The Jornal de Pediatria aims to be a source of scientific knowledge for Brazilian and international pediatric researchers. Due to the quality of the published material, the Jornal de Pediatria's impact factor increased i...
Microarray-based comparative genomic hybridization analysis in neonates with congenital anomalies: detection of chromosomal imbalances
Objective To identify chromosomal imbalances by whole-genome microarray-based comparative genomic hybridization (array-CGH) in DNA samples of neonates with congenital anomalies of unknown cause from a birth defects monit...
Influence of maternity leave on exclusive breastfeeding
Objectives To describe the profile of women with children aged under 4 months living in the Brazilian state capitals and in the Federal District according to their working status and to analyze the influence of maternity...
Age at introduction of ultra-processed food among preschool children attending day-care centers
Objective To identify the age of introduction of ultra-processed food and its associated factors among preschool children. Methods Cross-sectional study carried out from March to June 2014 with 359 preschool children ag...