Could Cow'S Milk Fractions Contribute Tolmprove Diagnosis Of Ige Mediated Cow'S Milk Allergy?

RationaleThe contribution of IgE specific cow's milk fractions measurement are not well established in cow's milk allergy diagnosis. The aim is to evaluate its contribution especially in patients with negative whole milk specific IgE.MethodsIt were included patients with IgE mediated cow's milk allergy (clinical history, laboratorial data associated to anaphylaxis and/or positive DBPCFC).Skin prick-test was considered positive with wheal ≥3 mm and ImmunoCAP values ≥3,5 kUA/ml. The patients who presented negative skin prick test and/or ImmunoCap to whole milk were submitted to SPT or ImmunoCAP to CM fractions.ResultsSpecific IgE by ImmunoCAP were done in 70 patients, 43 (61,4%) were positive and 27 (38,6%) were negative. Among negatives patients, 7 (25,9%) presented at least one positive fraction (5 alphalactoalbumin, 3 betalactoglobulin and 1 casein). Regarding SPT from 101 tests, 78 (77,2%) were positive to whole milk and 23 (22,8%) negatives. From negative patients, 18 (78,2%) presented at least one positive fraction (12 alphalactoalbumin, 13 betalactoglobulin and 9 casein). Considering association between ImmunoCAP and SPT it was found 14 patients that presented positive SPT to whole milk when ImmunoCAP was negative.ConclusionDiagnosis of cow's milk allergy can be improved associating research of IgE cow's milk fractions. SPT to whole milk may also contibute for diagnosis specially in patients with negative ImmunoCAP. RationaleThe contribution of IgE specific cow's milk fractions measurement are not well established in cow's milk allergy diagnosis. The aim is to evaluate its contribution especially in patients with negative whole milk specific IgE. The contribution of IgE specific cow's milk fractions measurement are not well established in cow's milk allergy diagnosis. The aim is to evaluate its contribution especially in patients with negative whole milk specific IgE. MethodsIt were included patients with IgE mediated cow's milk allergy (clinical history, laboratorial data associated to anaphylaxis and/or positive DBPCFC).Skin prick-test was considered positive with wheal ≥3 mm and ImmunoCAP values ≥3,5 kUA/ml. The patients who presented negative skin prick test and/or ImmunoCap to whole milk were submitted to SPT or ImmunoCAP to CM fractions. It were included patients with IgE mediated cow's milk allergy (clinical history, laboratorial data associated to anaphylaxis and/or positive DBPCFC). Skin prick-test was considered positive with wheal ≥3 mm and ImmunoCAP values ≥3,5 kUA/ml. The patients who presented negative skin prick test and/or ImmunoCap to whole milk were submitted to SPT or ImmunoCAP to CM fractions. ResultsSpecific IgE by ImmunoCAP were done in 70 patients, 43 (61,4%) were positive and 27 (38,6%) were negative. Among negatives patients, 7 (25,9%) presented at least one positive fraction (5 alphalactoalbumin, 3 betalactoglobulin and 1 casein). Regarding SPT from 101 tests, 78 (77,2%) were positive to whole milk and 23 (22,8%) negatives. From negative patients, 18 (78,2%) presented at least one positive fraction (12 alphalactoalbumin, 13 betalactoglobulin and 9 casein). Considering association between ImmunoCAP and SPT it was found 14 patients that presented positive SPT to whole milk when ImmunoCAP was negative. Specific IgE by ImmunoCAP were done in 70 patients, 43 (61,4%) were positive and 27 (38,6%) were negative. Among negatives patients, 7 (25,9%) presented at least one positive fraction (5 alphalactoalbumin, 3 betalactoglobulin and 1 casein). Regarding SPT from 101 tests, 78 (77,2%) were positive to whole milk and 23 (22,8%) negatives. From negative patients, 18 (78,2%) presented at least one positive fraction (12 alphalactoalbumin, 13 betalactoglobulin and 9 casein). Considering association between ImmunoCAP and SPT it was found 14 patients that presented positive SPT to whole milk when ImmunoCAP was negative. ConclusionDiagnosis of cow's milk allergy can be improved associating research of IgE cow's milk fractions. SPT to whole milk may also contibute for diagnosis specially in patients with negative ImmunoCAP. Diagnosis of cow's milk allergy can be improved associating research of IgE cow's milk fractions. SPT to whole milk may also contibute for diagnosis specially in patients with negative ImmunoCAP.