Diagnostic accuracy of atopy patch test in children with cow's milk allergy.

Q2 Medicine

Clinical and Molecular Allergy Pub Date : 2023-04-07 DOI:10.1186/s12948-023-00183-6

Prapasri Kulalert, Padcha Pongcharoen, Paskorn Sritipsukho, Sukkrawan Intraakhao, Punnapat Piriyanon, Patcharapa Thaweekul, Sira Nanthapisal, Orapan Poachanukoon

{"title":"Diagnostic accuracy of atopy patch test in children with cow's milk allergy.","authors":"Prapasri Kulalert, Padcha Pongcharoen, Paskorn Sritipsukho, Sukkrawan Intraakhao, Punnapat Piriyanon, Patcharapa Thaweekul, Sira Nanthapisal, Orapan Poachanukoon","doi":"10.1186/s12948-023-00183-6","DOIUrl":null,"url":null,"abstract":"Background: The accuracy of an atopy patch test (APT) for fresh cow's milk allergy is controversial. Few studies have focused on commercial extract solutions. We aimed to evaluate the diagnostic performance of the APT in cow's milk allergic children using fresh cow's milk and commercial extracts of cow's milk and its components including casein, α-lactalbumin, and β-lactoglobulin.Methods: A prospective study was carried out in children with a history of cow's milk allergy. Children underwent the skin prick test (SPT) and APT with fresh cow's milk, powdered cow's milk, and commercial extracts of cow's milk, casein, α-lactalbumin, and β-lactoglobulin. Oral food challenge (OFC) was confirmed in all children.Results: A total of 37 patients participated (mean age 13.14 ± 7.26 months). Only 5 (13.51%) patients had positive OFC to cow's milk. The sensitivity of the APT using fresh cow's milk was 40%, specificity was 65.6%, PPV was 15.4%, and NPV was 87.5%. The sensitivity of the APT using powdered cow's milk was 40%, 60.7% for specificity, 15.4% for PPV, and 58% for NPV. The sensitivity and PPV of the APT using commercial solutions of cow's milk, casein, α-lactalbumin, and β-lactoglobulin were zero. The specificities were 90.6%, 93.8%, 100%, and 100% for α-lactalbumin, cow's milk, casein, and β-lactoglobulin, respectively.Conclusions: APT using commercial solutions showed higher specificity than fresh milk. The specificity increased using a protein component allergen.","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080736/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Molecular Allergy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s12948-023-00183-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The accuracy of an atopy patch test (APT) for fresh cow's milk allergy is controversial. Few studies have focused on commercial extract solutions. We aimed to evaluate the diagnostic performance of the APT in cow's milk allergic children using fresh cow's milk and commercial extracts of cow's milk and its components including casein, α-lactalbumin, and β-lactoglobulin.

Methods: A prospective study was carried out in children with a history of cow's milk allergy. Children underwent the skin prick test (SPT) and APT with fresh cow's milk, powdered cow's milk, and commercial extracts of cow's milk, casein, α-lactalbumin, and β-lactoglobulin. Oral food challenge (OFC) was confirmed in all children.

Results: A total of 37 patients participated (mean age 13.14 ± 7.26 months). Only 5 (13.51%) patients had positive OFC to cow's milk. The sensitivity of the APT using fresh cow's milk was 40%, specificity was 65.6%, PPV was 15.4%, and NPV was 87.5%. The sensitivity of the APT using powdered cow's milk was 40%, 60.7% for specificity, 15.4% for PPV, and 58% for NPV. The sensitivity and PPV of the APT using commercial solutions of cow's milk, casein, α-lactalbumin, and β-lactoglobulin were zero. The specificities were 90.6%, 93.8%, 100%, and 100% for α-lactalbumin, cow's milk, casein, and β-lactoglobulin, respectively.

Conclusions: APT using commercial solutions showed higher specificity than fresh milk. The specificity increased using a protein component allergen.

查看原文本刊更多论文

特应性斑贴试验对儿童牛奶过敏诊断的准确性。

背景:特应性斑贴试验(APT)对鲜奶过敏的准确性存在争议。很少有研究关注商业提取物解决方案。我们的目的是评估APT对牛奶过敏儿童的诊断性能，使用新鲜牛奶和牛奶的商业提取物及其成分，包括酪蛋白、α-乳清蛋白和β-乳球蛋白。方法:对有牛奶过敏史的儿童进行前瞻性研究。儿童分别用鲜奶、奶粉、商品牛奶提取物、酪蛋白、α-乳清蛋白和β-乳球蛋白进行皮肤点刺试验(SPT)和APT。所有儿童均确诊为口腔食物挑战(OFC)。结果:共37例患者参与，平均年龄13.14±7.26个月。仅有5例(13.51%)患者对牛奶的OFC阳性。鲜奶对APT的敏感性为40%，特异性为65.6%，PPV为15.4%，NPV为87.5%。使用奶粉的APT的敏感性为40%，特异性为60.7%，PPV为15.4%，NPV为58%。使用牛奶、酪蛋白、α-乳清蛋白和β-乳球蛋白的商业溶液，APT的敏感性和PPV均为零。α-乳清蛋白、牛奶、酪蛋白和β-乳球蛋白的特异性分别为90.6%、93.8%、100%和100%。结论:商用溶液对APT的特异性高于鲜奶。使用蛋白质成分过敏原时，特异性增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical and Molecular Allergy Medicine-Immunology and Allergy

CiteScore

8.20

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： Clinical and Molecular Allergy is an open access, peer-reviewed, online journal that publishes research on human allergic and immunodeficient disease (immune deficiency not related to HIV infection/AIDS). The scope of the journal encompasses all aspects of the clinical, genetic, molecular and inflammatory aspects of allergic-respiratory (Type 1 hypersensitivity) and non-AIDS immunodeficiency disorders. However, studies of allergic/hypersensitive aspects of HIV infection/AIDS or drug desensitization protocols in AIDS are acceptable. At the basic science level, this includes original work and reviews on the genetic and molecular mechanisms underlying the inflammatory response.