Accuracy of serum IgE concentrations and papule diameter in the diagnosis of cow's milk allergy

Franco, Jackeline; Pinheiro, Aline Antunes de Cerqueira; Vieira, Sarah Cristina Fontes; Barreto, Íkaro Daniel de Carvalho; Gurgel, Ricardo Queiróz; Cocco, Renata Rodrigues; Solé, Dírceu

doi:10.1016/j.jped.2017.06.022

Cited by 13 publications

(30 citation statements)

References 30 publications

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“…We tried to define new optimal cut-offs by Youden's index and the maximum specificity criterion. Using Youden's index, it was found to be 3.75 mm, which was comparable to those reported before by Franco et al (3.5 mm) [24] and Neves et al (4.5 mm) [27]. However, for the maximum specificity, the cut-off was 4.75 mm which was comparable to those reported by Franco et al [24] (5 mm) and Sporik et al (6 mm) [17] but smaller than those reported by other authors (8-13.8 mm) [16, 19, 21-23, 26, 27].…”

Section: Resultssupporting

confidence: 89%

“…We found a high statistically significant variance between allergic and non-allergic infants regarding the wheel diameter and the levels of sIgE and with the allergic group having a larger wheel diameter (6.29±3.58 vs 2.12±0.96) mm and higher sIgE levels (0.50±0.21 vs 0.29±0.06) KUA/L (P value <0.001 for both) as shown in (Table 2). Similarly, previous studies have reported significant differences between allergic and non-allergic patients regarding the results of SPT and sIgE serum levels [19,24,27] SPT is a simple in vivo technique to assess the existence of IgE sensitization. When a specific allergen is brought through a lancet into the skin of allergic patients, dermal mast cells degranulate due to the crosslinking of allergen-sIgE attached to Elbawwab, E., et al their membrane receptors.…”

Section: Resultsmentioning

confidence: 82%

“…On performing oral challenge tests, only 72 infants (70.59%) developed allergic reactions and were confirmed as CMA. The prevalence of CMA varies widely among different studies (from 41 up to 79%) [16][17][18][19][20][21][22][23][24][25][26][27] due to different selection criteria of the studied children regarding their age and clinical presentation, in addition to, different protocols used to perform the OCT. Food challenge tests are time-consuming, expensive and not free of undesirable effects and so, there is a great demand for more simple diagnostic procedures [10].…”

Section: Resultsmentioning

confidence: 99%

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Illicit Drugs and Alcohol: Driving Performance

Elbawwab

Ebrahim

Hassan

et al. 2022

Zagazig University Medical Journal

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Background: Cow's Milk protein allergy (CMA) is a common finding in infants and young children (2-3%). Its diagnosis is a multifaceted aspect including medical history, clinical examination, diagnostic elimination diets, oral challenge tests (OCT), skin prick tests (SPTs) and specific immunoglobulin E (sIgE) measurements. We aimed to assess the value of SPT and sIgE for diagnosis of infants with CMA in routine clinical practice. Methods: This cross-sectional study included 102 infants with suspected CMA. They were subjected to OCT, SPT with pasteurized cow's milk and measurement of serum sIgE for cow's milk by immunoblot technique. Results: Seventy-two infants (70.59%) showed positive allergic reactions with OCT. Comparing SPT to OCT, sensitivity was 75%, specificity was 68.7%, predictive value for negative (PVN) was 59% and predictive value for positive (PVP) was 93.1%. Comparing sIgE to OCT, sensitivity was 68.1%, specificity was 96.7%, PVN was 69% and PVP was 98%. Comparing both SPT and sIgE together to OCT, sensitivity was 62.5%, specificity was 96.6%, PVN was 51.8% and PVP was 97.8%. Conclusions: For clinical practice, our findings suggest that correlation between SPT and sIgE is significant regarding CMA diagnosis. Therefore, these tests can be used together for diagnosis of CMA. However, still some cases can be only diagnosed with positive OCT with non-detectable sensitization. Therefore, a detailed history is a major factor in assessing CMA. In addition, definition of new optimal cut-offs for sIgE and SPT to cow's milk can improve the accuracy of these tests, hoping to avoid unnecessary and potentially dangerous OTC.

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Section: Resultssupporting

confidence: 89%

Section: Resultsmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 99%

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Illicit Drugs and Alcohol: Driving Performance

Elbawwab

Ebrahim

Hassan

et al. 2022

Zagazig University Medical Journal

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“…Quando é observado algum sintoma característico relativo à APLV, é recomendada a restrição de dieta, que consiste na eliminação completa do consumo de leite e seus derivados. A restrição, em um primeiro momento, é importante a fim de evitar males ao paciente (Brisotti et al, 2018) (Neves et al, 2016;Franco et al, 2018).…”

Section: Diagnóstico E Tratamento Da Alergia a Proteína Do Leite De Vacaunclassified

Diferenciação de diagnósticos e tratamentos entre alergia e intolerância ao leite

Alves

Lima

Martins

2021

RSD

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A Alergia a Proteína do Leite de Vaca (APLV) é uma alergia alimentar, mais frequente em crianças e é desencadeada por uma resposta imunológica. A Intolerância à Lactose (IL) está relacionada com a má absorção da lactose devido a inatividade ou deficiência da enzima lactose. A fim de resguardar a saúde da população, principalmente as crianças, é objetivado demonstrar a importância do diagnóstico da IL e da APLV, a diferenciação entre as condições e seus diagnósticos e tratamento. O diagnóstico da APLV é realizado através de anamnese, teste físico, pesquisa de anticorpos e o teste de provocação oral. O tratamento primário é a exclusão do consumo do leite de vaca, podendo incluir o uso de corticoides e anti-histamínicos. O diagnóstico da IL pode ser realizado por teste de tolerância e medição da atividade da lactase. O tratamento da IL é a suspensão do consumo do leite e/ou a terapia de reposição da enzima lactase. O método Food Detective não é adequado para diagnosticas APLV ou IL. O diagnóstico das duas condições deve ser realizado com cautela, visto que a exclusão do leite da alimentação pode interferir nos níveis de nutrientes necessários, principalmente nas crianças.

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“…13 Approximately 60% of milk-induced adverse reactions were caused by immunoglobulin E (IgE), affecting one or more organs. 14 The typical symptoms of IgE-mediated CMPA often appeared within 1-2 h of milk ingestion. Conventional CMPA diagnostic methods included avoidance-provocation test, serological specificity immunoglobulin E (sIgE) testing, skin prick testing (SPT), and patch testing.…”

Section: Introductionmentioning

confidence: 99%

Investigation of serum IL-12, IL-16, and IL-17A as diagnostic biomarkers in children with cow’s milk protein allergy

Mao

Liu

et al. 2022

Allergol Immunopathol

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Background: Cow’s milk protein allergy (CMPA) is an abnormal immune response caused by milk proteins and is most common in infancy and early childhood. Statistics revealed up to 7.5% of children suffered from milk allergy. Its clinical symptoms were characterized by diversity, non-specificity, and can affect multiple systems, including the digestive tract, skin, and respiratory tract. In this study, we aimed to investigate the effects of IL-12, IL-16, and IL-17A on diagnosing and monitoring CMPA in children for clinical treatment. Methods: A total of 158 infants with CMPA and 89 healthy babies were recruited and evalu-ated. Demographic and clinical information of all participants were recorded. An extensive analysis of inflammatory cytokine levels, including IL-12, IL-16, and IL-17A, was performed in blood samples from 247 infants younger than 9 months. Meanwhile, the serological specificity immunoglobulin E (sIgE) levels were evaluated. In addition, the area under the curve (AUC) values of IL-12, IL-16, and IL-17A in differentiating CMP from healthy babies were measured by receiver operating characteristic analysis. Finally, the correlation between sIgE and IL-12, IL-16, and IL-17A levels were detected using Spearman correlation analysis. Results: Compared with healthy control, infants who developed CMPA had decreased IL-12, increased IL-16, and IL-17A. Moreover, a significant correlation between serum IL-12, IL-16, IL-17A and sIgE levels was observed in the CMPA group. In addition, AUC values of IL-12, IL-16, and IL-17A in discriminating CMPA from healthy infants were 0.8425, 0.9196, and 0.8813, respectively. Finally, IL-12 was increased while IL-16 and IL-17A levels were decreased in the CMPA group after three months of milk avoidance treatment. Conclusions: We found that IL-12, IL-16, and IL-17A levels in children with CMPA were associated with SCORAD scores, sIgE levels, and disease severity, functioning as valuable disease-monitor markers in CMPA.

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Accuracy of serum IgE concentrations and papule diameter in the diagnosis of cow's milk allergy

Abstract: 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.

Cited by 13 publications

References 30 publications

Illicit Drugs and Alcohol: Driving Performance

Illicit Drugs and Alcohol: Driving Performance

Diferenciação de diagnósticos e tratamentos entre alergia e intolerância ao leite

Investigation of serum IL-12, IL-16, and IL-17A as diagnostic biomarkers in children with cow’s milk protein allergy

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