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  • Meeting abstract
  • Open Access

Are there predictive symptoms/signs for a positive oral cow's milk challenge in patients suspected of cow's milk allergy?

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World Allergy Organization Journal20158:543

https://doi.org/10.1186/1939-4551-8-S1-A31

  • Published:

Background

Cow’s Milk (CM) is the main allergen involved in food allergy in children and it is responsible for the majority of Oral Food Challenges in our unit. The aim of this study was to describe differences between children with negative and positive CM food challenge (CMFC).

Methods

128 children with suspected CMA were undergone to CMFC (June/2007 to Feb/2014) and comprised two groups according to the result: negative test (passed, PG, n=100) and positive test (failed, FG, n=28). Both groups were analyzed regarding to age at first reaction, gender, nutritional status, breastfeeding, familial history of FA, symptoms reported, presence of asthma, allergic rhinitis or atopic dermatitis and results of skin prick test (SPT). FG was analyzed according to required amount of CM to elicit reaction, symptoms and severity of reaction.

Results

Comparing both groups, FG was significantly associated with patient’s reports of urticaria (79% x 40%, OR=5.5; 95%IC:2.1-14.8; p=0.05), pruritus (46% x 7%; OR=28.0; 95%IC:7.1-110.1; p<0.0001), vomiting (54% x 26%; OR=3.3; 95%IC:1.4-7.8; p=0.01), rhinoconjuctivitis (18% x 5%; OR=4.1; 95%IC:1.1-15.5; p=0.04) and anaphylaxis (36% x 16%; OR=2.9; 95%IC:1.1-7.5; p=0.03). Gender, age at first reaction, exclusively breasfeeding, familial history of FA, presence of other atopic diseases and diameter of SPT (histamine, CM and milk fractions) did not differ between the groups. Less than 10% of all children were underweight. The median amount of CM to elicit a reaction during CMFC was 13mL and it was not related to severity of symptoms, presence of atopic diseases or age at first reaction. During CMFC, 50% of FG patients presented with urticaria and 14%, an anaphylactic reaction.

Conclusions

Although CMA has been frequently suspected in Brazilian children, just a little amount (21.8%) really confirmed the diagnosis. There were no specific clinical characteristics for a positive CMFC reaffirming the need of CMFC for the diagnosis of CMA.

Authors’ Affiliations

(1)
Federal University of Sao Paulo, Brazil

Copyright

© Rozalem et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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