Abstract
Atopy patch tests (APTs) have been proposed for the diagnostic approach in children with non-IgE-mediated cow's milk allergy and gastrointestinal symptoms. We aimed to investigate the benefit of APTs in predicting oral tolerance in these patients. We prospectively evaluated 172 subjects with a sure diagnosis of non-IgE-mediated CMA and gastrointestinal symptoms (97 boys, 56.4%; age, 6.37 m; range, 2-12 m). At diagnosis, 113/172 (65.7%) children had positive APTs to cow's milk proteins (CMP). After 12 months of exclusion, diet APTs were repeated immediately before OFC. APTs significantly correlated (P < 0.001) with the OFC outcome (r 0.579). Diagnostic accuracy was sensitivity of 67.95%, specificity of 88.3%, PPV of 82.81%, NPV of 76.85%, and a +LR of 5.80. APTs are a valuable tool in the follow-up of children with non-IgE-mediated CMA-related gastrointestinal symptoms by contributing in determining whether an OFC can safely be undertaken.
Highlights
Oral food challenge (OFC) is required to establish the persistence or resolution of cow’s milk allergy (CMA)
We aim to investigate the benefit of Atopy patch test (APTs) in predicting a reaction to the OFC in children with non-IgEmediated CMA
All tests were performed by the same nursing staff, and the results were read by two expert pediatric allergists blind to the outcome of OFC
Summary
Atopy patch tests are useful to predict oral tolerance in children with gastrointestinal symptoms related to non-IgE-mediated cow’s milk allergy. R Nocerino1*, V Granata, V Pezzella, L Leone, M Di Costanzo, A Passariello, G Terrin, R Troncone, R Berni Canani. From Food Allergy and Anaphylaxis Meeting (FAAM 2013) Nice, France. From Food Allergy and Anaphylaxis Meeting (FAAM 2013) Nice, France. 7-9 February 2013
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