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Medientyp:
E-Artikel
Titel:
Diagnostic value of skin‐prick and patch tests and serum eosinophil cationic protein and cow's milk‐specific IgE in infants with cow's milk allergy
Beteiligte:
Saarinen, K. M.;
Suomalainen, H.;
Savilahti, E.
Beschreibung:
<jats:p>The diagnosis of cow's milk allergy is based on a clinical response to an elimination‐challenge test with cow's milk.</jats:p><jats:p>We studied the usefulness of the skin‐prick and patch tests and measurement of cow's milk‐specific IgE and eosinophil cationic protein in serum as diagnostic tools for cow's milk allergy in a cohort of 6209 unselected infants followed from birth for the development of cow's milk allergy.</jats:p><jats:p>Of the 239 infants challenged with cow's milk, 118 showed a positive and 121 a negative response at a mean age of 6.9 months. A positive reaction to a skin‐prick test with cow's milk ( 3 mm) was seen in 72 (61%) and 29 (24%) infants with positive and negative challenges, elevated serum cow's milk‐specific IgE ( 0.7 kU/L) in 52 (45%) and 15 (13%) infants, a positive reaction to patch test with cow's milk protein fractions in 26 (26%) and eight (8%) infants, and elevated serum eosinophil cationic protein ( 20 μg/L) in 22 (21%) and seven (13%) infants, respectively. Parallel use of the four tests with the above‐mentioned cut‐off values correctly classified 73% of the infants with a sensitivity of 0.76 and a specificity of 0.67. An immediate reaction to cow's milk challenge correlated with skin prick test positivity and elevated serum milk‐specific IgE, and tended to correlate with patch test positivity.</jats:p><jats:p>No single test or parallel use of the four tests could predict the challenge outcome acceptably in this prospectively followed, unselected cohort of 6209 infants. A positive reaction to one or more tests needs to be confirmed by a challenge test and a negative response to all four tests does not rule out the possibility of cow's milk allergy.</jats:p>