The utility of casein skin prick test and IgE values in predicting anaphylaxis and reactivity to baked milk

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-06-01 DOI:10.1016/j.anai.2025.03.020

Mujde Tuba Cogurlu MD , Nezihe Nefise Uluc MD , Ismail Ozanli MD , Yeşim Ece Ozkan MD , Nagihan Iskender MD , Sibel Balci MD , Isıl Eser Simsek MD , Metin Aydogan MD

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引用次数: 0

Abstract

Background

Most children with milk allergy can tolerate baked milk (BM); however, a small percent still react to it. Identifying indicators that might forecast potential reactions to baked goods is essential.

Objective

To determine the predictive factors and some decision points for estimation of BM reactivity and severe reactions.

Methods

A cross-sectional study was performed. Participants who were reactive to unheated milk underwent an oral food challenge with BM. The reactive group was classified into anaphylactic and non-anaphylactic reaction categories. The IgE and skin prick test (SPT) levels of milk and its components were compared among these groups.

Results

The study was conducted with 110 patients. The median age of participants was 16 (IQR: 12-31) months. BM reactivity was observed in 41% (n = 46/110) of the patients. The optimal cutoff point for BM reactivity was 4.68 kIU/L for casein specific IgE (sIgE) (84% specificity, 75% sensitivity, area under the curve [AUC]: 0.827) and 7 mm for casein SPT (87.2% specificity, 51.1% sensitivity, AUC: 0.721) (P < .001, P < .001). The positive decision point for anaphylaxis for casein sIgE was 34 kIU/L (95% specificity, 47.6% sensitivity, AUC: 0.707). In the group younger than 24 months old, the cutoff values for casein sIgE were found to be 5.4 kIU/L (95% specificity, 66.6% sensitivity, AUC: 0.844) and casein SPT at 7 mm (91% specificity, 37% sensitivity, AUC: 0.708) (P < .001, P = .002).

Conclusion

Our investigation revealed that the most accurate indicator for BM reactivity was casein sIgE and SPT. Although we established a threshold for severe reaction with BM in our study population, we consider that our findings require validation before therapeutic implementation.

查看原文本刊更多论文

酪蛋白spt和IgE值在预测过敏反应和对烘焙牛奶的反应中的应用。

背景：大多数牛奶过敏儿童可以耐受烘焙牛奶；然而，仍有一小部分人对此有反应。确定可能预测烘焙食品潜在反应的指标至关重要。目的：本研究的目的是确定预测因素和一些决策点，以估计烘焙牛奶的反应性和严重反应。方法：横断面研究。对未加热牛奶有反应的参与者接受了用烘焙牛奶进行的口腔食物挑战。反应组分为过敏反应组和非过敏反应组。比较各组乳汁及其成分的免疫球蛋白E和皮肤点刺试验水平。结果：本研究共纳入110例患者。参与者的中位年龄为16个月（IQR:12-31）。在41%（46/110）的患者中观察到烘焙牛奶反应性。酪蛋白- sige的最佳临界值为4.68kIU/L（特异性84%，敏感性75%，AUC:0.827），酪蛋白-SPT的最佳临界值为7mm（特异性87.2%，敏感性51.1%,AUC:0.721）(结论：我们的研究表明，酪蛋白- spige和SPT是最准确的BM反应性指标。虽然我们在研究人群中建立了BM严重反应的阈值，但我们认为我们的发现需要在治疗实施之前进行验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.