Practical interest of both skin prick test and specific IgE in the evaluation of tolerance acquisition in IgE mediated cow's milk allergy (CMA). A clinical retrospective study in a cohort of 184 children

Payot, F.; Berthiller, Julien; Kassai, Behrouz; Brunet, Anne; Villard-Truc, F.; Lachaux, A.

doi:10.1016/j.aller.2013.03.007

Cited by 7 publications

(11 citation statements)

References 12 publications

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“…Presence of anaphylaxis was the only clinical aspect that showed significant differences between persistent and tolerant groups (Table 1), as previously shown in the same service by Jacob et al 2 Atopic dermatitis had no significant influence on this difference, as described by Payot et al 13 Factors previously described such as asthma and allergies to other foods were identified as independent predictors for persistent CMPA after the age of 2 years, 14 not observed in the present study.…”

Section: Discussionsupporting

confidence: 79%

“…The main limitation of our study is sample size, which did not allow the development of a ROC curve as performed by Payot et al 13 When we analyze the values of median SPT at diagnosis and at the time of tolerance acquisition, there was a de- cline of over 50% (6 mm vs. 2 mm), which may be indicative of OFC to confirm CMP tolerance associated with a favorable clinical outcome. We did not find in the literature values comparable to our results.…”

Section: Discussionmentioning

confidence: 94%

“…On the other hand, in the persistent group, the decline was lower than 50% (7 mm vs. 5 mm), suggesting that the moment was not ideal to perform an OFC. In a recent publication by Payot et al, 13 the authors found a probability of 80% of negative OFC with SPT wheal size equal to zero, specific IgE for CM at 0.85 kU/L and IgE to casein for 0.73 kU/L, values that can be difficult to achieve in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Statistically significant SPT values for tolerance, investigated in 178 children and confirmed by OFC, were found by Payot et al, corresponding to 2.2 in tolerant vs. 5.1 mm in persistent patients, results very similar to our data. 13 SPT has been used for decades to prove or rule out sensitization to allergens. Negative SPT results are used to confirm the absence of IgE-mediated reaction, with negative predictive value (NPV) exceeding 95%.…”

Section: Discussionmentioning

confidence: 99%

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Cow’s milk allergy: Evaluating tolerance through skin-prick test

Neves

Beck

Gushken

et al. 2016

Rev. Assoc. Med. Bras.

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Objective: To evaluate the wheal diameter in allergy skin-prick tests (SPT) with cow's milk extract (CM) comparing tolerant and persistent patients. Method: A retrospective cohort study involving database analysis of children with diagnosis of cow's milk protein allergy (CMPA) mediated by immunoglobulin E in a specialized outpatient clinic that regularly performed SPT between January 2000 and July 2015. Patients were allocated into two groups: tolerant or persistent. Comparisons were made at diagnosis and over time between tolerant and persistent patients using Fisher's, Mann-Whitney or Wilcoxon tests and significance level at 5%. Results: After applying inclusion and exclusion criteria, the sample includes 44 patients (29 tolerant and 15 who persisted with CMPA). In the tolerant group, the medians of SPT were: 6 mm at diagnosis and 2 mm at the development of tolerance; a significant difference (p<0.0001) was found. In the persistent group, the median SPT at diagnosis was 7 mm, while in the last SPT it was 5 mm, with no statistical difference (p=0.173). The comparison of medians in the last SPT between groups was significant (p=0.001), with a reduction greater than 50% in SPT in the tolerant group. Conclusion: Serial SPTs were useful for diagnosis, and a decrease higher than 50% in diameter can indicate the moment to perform oral food challenge (OFC) tests, helping to detect tolerance in CMPA.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cow’s milk allergy: Evaluating tolerance through skin-prick test

Neves

Beck

Gushken

et al. 2016

Rev. Assoc. Med. Bras.

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“…Para confirmação da presença de alergia, os procedimentos diagnósticos mais comuns são o teste da imunoglobulina E (IgE) específica e o teste cutâneo (TC) [5]. O TC é o método mais utilizado na área clínica para investigação de sintomas alérgicos, sendo considerado o teste padrão na avaliação de sensibilização a alérgenos [6], sendo um método rápido, simples e bastante acessível.…”

Section: Introductionunclassified

Teste cutâneo em doenças alérgicas: uma revisão sistemática

Soldera

Bugança

Santos

et al. 2015

Sci Med

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RESUMOObjetivos: Identificar os principais alérgenos aplicados em testes cutâneos para sensibilização atópica em pacientes com diagnóstico de asma e rinite alérgica. Métodos: Uma revisão sistemática foi realizada para identificar estudos clínicos nos últimos 10 anos, tendo como desfecho a utilização do teste cutâneo (prick test) no diagnóstico de asma e rinite alérgica. Foi realizada uma pesquisa nas bases de dados PubMed, Scielo e ScienceDirect. Foram incluídos artigos que abordam a utilização direta do teste cutâneo no diagnóstico das doenças alérgicas. Além disso, os estudos obrigatoriamente deveriam descrever o protocolo de utilização, bem como os alérgenos aplicados no teste. Para seleção dos artigos, três pesquisadores analisaram de forma independente os critérios de inclusão, sendo os mesmos analisados por mais dois revisores. Resultados: Treze instrumentos foram incluídos na sistemática, tendo uma variação expressiva na quantidade de reagentes (de 3 a 36 tipos). Dos 36, cinco possuíram a maior frequência de positividade à sensibilização (Artemisia vulgaris, Dermatophagoides farinae, Dermatophagoides pteronyssinus, epitélios de cão e de gato). Como parte do protocolo de aplicação, a região do antebraço e o período de 15 a 20 minutos são os mais frequentes. Conclusões: Alérgenos mais comuns em alergia respiratória foram descritos, sendo importante levar em consideração a região e população investigadas.DESCRITORES: testes cutâneos; diagnóstico; asma; rinite. ABSTRACT Aims:To identify the major allergens used in skin tests for atopic sensitization in patients with asthma and allergic rhinitis. Methods: A systematic review was performed to identify clinical studies in the past 10 years whose outcomes included the skin test (prick test) in the diagnosis of asthma and allergic rhinitis. The PubMed, SciELO, and ScienceDirect databases were searched and articles that addressed the direct use of skin testing in the diagnosis of allergic diseases were included. In addition, the studies had to describe the protocol and the allergens used in the test. For selection of the articles, three researchers independently analyzed the inclusion criteria, which were analyzed by two other reviewers. Results: Thirteen instruments were included in the systematic review, and the amount of reagents used varied significantly (between 3 and 36). Of the 36 reagents, five had the highest frequency of positive sensitization (Artemisia vulgaris, Dermatophagoides farinae, Dermatophagoides pteronyssinus, dog and cat epithelia). As part of the application protocol, the forearm and the period of 15-20 minutes are the most frequently used. Conclusions:The most frequently detected allergens were described, and both the region and the studied population are important factors to be considered.

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Quoi de neuf en allergologie pédiatrique en 2014 ? Épidémiologie générale, diagnostic (précoce), traitement, anaphylaxie, allergie alimentaire, médicamenteuse et aux venins et salives d’insectes (une revue de la littérature internationale 2014)

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Revue Française d'Allergologie

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Practical interest of both skin prick test and specific IgE in the evaluation of tolerance acquisition in IgE mediated cow's milk allergy (CMA). A clinical retrospective study in a cohort of 184 children

Abstract: This study confirms the practical interest of both SPT and sIgE in the evaluation of tolerance induction in IgE-mediated CMPA, but with no corresponding results. Sensitivity, specificity and probability curves of success for cow's milk challenge can be determined and have clinical utility.

Cited by 7 publications

References 12 publications

Cow’s milk allergy: Evaluating tolerance through skin-prick test

Cow’s milk allergy: Evaluating tolerance through skin-prick test

Teste cutâneo em doenças alérgicas: uma revisão sistemática

Quoi de neuf en allergologie pédiatrique en 2014 ? Épidémiologie générale, diagnostic (précoce), traitement, anaphylaxie, allergie alimentaire, médicamenteuse et aux venins et salives d’insectes (une revue de la littérature internationale 2014)

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