PMID- 37160745
OWN - NLM
STAT- MEDLINE
DCOM- 20230511
LR  - 20230524
IS  - 1539-6304 (Electronic)
IS  - 1088-5412 (Linking)
VI  - 44
IP  - 3
DP  - 2023 May 1
TI  - Comparison of commercial allergen extract with various milk products of skin 
      prick tests in diagnosing cow's milk protein allergy.
PG  - 193-199
LID - 10.2500/aap.2023.44.230012 [doi]
AB  - Introduction: In this study, we aimed to solve the incompatibilities between the 
      skin prick test (SPT) result and the clinical picture encountered among patients. 
      Thus, we used various milk products (raw, ultrahigh temperature [UHT], and 
      pasteurized cow's milk) with commercial milk allergen extract in patients we 
      think may have cow's milk protein allergy (CMPA) and made a comparison among the 
      milk types. Methods: This study was conducted retrospectively between February 1, 
      2019, to June 1, 2019, at a pediatric allergy polyclinic of the university 
      training/research hospital. A pair of 79 individuals, as control and patient 
      groups, ages between 1 month and 21 years who were presented with a suspicion of 
      CMPA and defined with SPT and/or allergen-specific immunoglobulin E (IgE) levels 
      were included in the study. Allergen-specific IgE tests (specific IgE cow's milk, 
      beta-lactoglobulin, alpha-lactalbumin, casein) were evaluated. SPT was performed with 
      fresh/raw, UHT, and pasteurized (daily) cow's milk besides the standard used 
      commercial extract. Results: In the group included in the study and defined as 
      IgE-mediated CMPA, 52.9% of the 79 patients were boys (n = 46), 47.1% were girls 
      (n = 33), and the median age was 6 months (5.0-8.0 months). In the group of 
      specific IgE cow's milk reaction that was sought, frequency and wheal 
      (induration) size of SPT reaction to fresh/raw milk was also found to be 
      statistically significant between positive- and negative-reaction groups, not 
      detected against other milk products. The area under the curve for the diagnostic 
      value of fresh milk was 93.1%. For the cutoff value of 2.50 mm, 88.1% sensitivity 
      and 90.8% specificity were determined. In the group of specific IgE 
      beta-lactoglobulin reaction searched, there was a statistically significant 
      difference in the frequency of SPT positivity and wheal size against UHT, fresh, 
      and daily/pasteurized milk between positive and negative reaction groups. When 
      the correlations of the mean induration axis in the tests were examined, it was 
      found that, among raw milk, daily milk, cow's milk allergen extract, and UHT 
      milk, a strong positive correlation was also statistically significant. 
      Conclusion: The positivity that could not be detected with SPT when using 
      allergen extract in a patient with positive specific IgE cow's milk result in the 
      clinic can be detected with SPT made with fresh (raw) milk, which can be an 
      alternative. In addition, specific IgE beta-lactoglobulin seems to be the most 
      compatible with the SPT wheal size (induration) of other milk types rather than 
      extract. Comparative studies of SPT allergen extracts and various milk types used 
      in the diagnosis of CMPA are very scarce in the literature, and more studies are 
      needed on this subject.
FAU - Sabit, Berat
AU  - Sabit B
AD  - From the Department of Pediatrics, Research and Training Hospital of Sakarya 
      University Medical Faculty, Sakarya University Medical Faculty, Sakarya, Turkiye.
FAU - Ozdemir, Oner
AU  - Ozdemir O
AD  - Division of Allergy and Immunology, Department of Pediatrics, Research and 
      Training Hospital of Sakarya University, Sakarya University Medical Faculty, 
      Sakarya, Turkiye, and.
FAU - Kose, Elif
AU  - Kose E
AD  - Department of Public Health, Sakarya University Medical Faculty, Sakarya, 
      Turkiye.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 0 (Lactoglobulins)
RN  - 0 (Allergens)
SB  - IM
MH  - Humans
MH  - Animals
MH  - Cattle
MH  - Female
MH  - Male
MH  - *Milk/adverse effects
MH  - *Milk Hypersensitivity/diagnosis
MH  - Retrospective Studies
MH  - Immunoglobulin E
MH  - Lactoglobulins
MH  - Allergens
EDAT- 2023/05/10 06:42
MHDA- 2023/05/11 06:42
CRDT- 2023/05/10 00:53
PHST- 2023/05/11 06:42 [medline]
PHST- 2023/05/10 06:42 [pubmed]
PHST- 2023/05/10 00:53 [entrez]
AID - 10.2500/aap.2023.44.230012 [doi]
PST - ppublish
SO  - Allergy Asthma Proc. 2023 May 1;44(3):193-199. doi: 10.2500/aap.2023.44.230012.