Atopy patch tests are useful to predict oral tolerance in children with gastrointestinal symptoms related to non-IgE-mediated cow's milk allergy

Allergy. 2013 Feb;68(2):246-8. doi: 10.1111/all.12071. Epub 2012 Dec 4.

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.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Animals
  • Cattle
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Gastrointestinal Diseases / etiology*
  • Gastrointestinal Diseases / physiopathology
  • Humans
  • Immune Tolerance*
  • Immunoglobulin E / immunology
  • Immunoglobulin E / metabolism
  • Infant
  • Male
  • Milk / adverse effects*
  • Milk Hypersensitivity / complications
  • Milk Hypersensitivity / diagnosis*
  • Milk Hypersensitivity / immunology
  • Milk Proteins
  • Patch Tests / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Factors

Substances

  • Milk Proteins
  • Immunoglobulin E