A pilot study on the application of a symptom-based score for the diagnosis of cow's milk protein allergy

SAGE Open Medicine
Yvan VandenplasDominik Grathwohl

Abstract

A challenge is the recommended test to diagnose cow's milk protein allergy. However, many parents and physicians prefer to not challenge because the procedure may cause (severe) symptoms. In clinical routine, diagnostic testing is only available for IgE-mediated allergy. The aim of this study was to test the diagnostic accuracy of a symptom-based score to select infants at risk of having cow's milk protein allergy. A symptom-based score was developed and consensus was reached that a score of ≥12 would select infants at risk of cow's milk protein allergy. Diagnosis of cow's milk protein allergy was demonstrated with a positive challenge after 1-month elimination diet. An open challenge was performed in 85/116 (73%) infants suspected of cow's milk protein allergy based on a symptom-based score ≥ 12 and was positive in 59/85 (69%). Although "a challenge test" was planned in the protocol, 27% of the parents refused the challenge. The mean decrease after 1 month of elimination diet with an extensive hydrolysate was -8.07 (95% confidence interval = -8.74, -7.40). If the symptom-based score during the elimination diet decreased to 6 or lower, 80% of the infants had a positive challenge test. If the symptom-based score remained >7, the...Continue Reading

References

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Citations

Feb 29, 2020·Immunity, Inflammation and Disease·Vincenzo FierroJesus Jiménez
Apr 7, 2015·Journal of Pediatric Gastroenterology and Nutrition·Christophe DupontMarie-José Butel
Apr 22, 2014·Pediatric Gastroenterology, Hepatology & Nutrition·Yvan VandenplasThierry Devreker
Jul 19, 2018·PloS One·Yvan VandenplasKoen Huysentruyt
Mar 25, 2020·Pediatric Gastroenterology, Hepatology & Nutrition·Karolina BigorajskaHania Szajewska
Jan 5, 2021·Journal of Pediatric Gastroenterology and Nutrition·Ana Muñoz-UrribarriYovani M Condorhuamán
May 11, 2021·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Georgina ThompsonChristopher Hyde
Jul 29, 2021·Pediatric Gastroenterology, Hepatology & Nutrition·Anna Kozłowska-JalowskaHania Szajewska

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