Evaluation of the skin-prick test for predicting the outgrowth of cow's milk allergy.
Evaluation of the skin-prick test for predicting the outgrowth of cow's milk allergy.
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评估皮肤点刺试验预测牛奶过敏的发展。
DOI：
10.2500/ar.2016.7.0175
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Matsumoto T
中科院分区：
文献类型：
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作者：
Kido J;Hirata M;Ueno H;Nishi N;Mochinaga M;Ueno Y;Yanai M;Johno M;Matsumoto T
尽管已经做出了相当大的努力来开发用于预测口服食物挑战的结果的诊断工具，但是仍然缺乏用于预测食物过敏的结果的测试。本研究的目的是评估的诊断价值的风团大小和皮肤指数（SI）（过敏原诱导的风团组胺诱导的风团直径的比值）的皮肤点刺试验的基础上的结果控制口服激发试验牛奶。此外，我们还评估了风团大小和/或SI是否可用于预测牛奶过敏（CMA）的副作用。这项研究包括135名疑似CMA的儿童。81例患者通过口服牛奶激发试验明确诊断，并测定其风团直径、SI和牛奶特异性血清免疫球蛋白E浓度。口腔激发试验阳性患儿的风团直径明显大于阴性患儿，SI明显高于阴性患儿。我们发现，50%的患者预计能够在5岁时喝牛奶。在这些患者中，与诊断时相比，CMA生长时的风团直径明显更小，SI明显更低，而在CMA未生长的患者中，这些值易于增加，无显著差异。皮肤点刺试验可用于CMA的诊断和预测CMA的发展。风团直径为8 mm或/和SI为1.0，不仅在诊断CMA方面，而且在预测CMA自然生长方面都是有用的。
Although considerable efforts have been made to develop diagnostic tools for predicting the outcome of oral food challenges, tests for predicting the outgrowth of food allergies are lacking. The aim of this study was to assess the diagnostic value of the wheal size and skin index (SI) (the ratio of an allergen-induced wheal to a histamine-induced wheal diameter) of the skin-prick test based on the outcome of a controlled oral provocation test for cow's milk. Moreover, we assessed whether wheal size and/or SI were useful for predicting the outgrowth of cow's milk allergy (CMA). This study included 135 children with suspected CMA. Eighty-one patients were definitely diagnosed by oral provocation tests for cow's milk, and their wheal diameters, SIs, and cow milk's–specific serum immunoglobulin E concentrations were determined. The wheal diameters were significantly larger and the SIs significantly higher in children with positive oral provocation test results than in those with negative test results. We found that 50% of the patients were expected to be able to drink cow's milk by age 5 years. In these patients, the wheal diameters were significantly smaller and the SIs significantly lower at the time of CMA outgrowth than at the time of diagnosis, whereas these values were apt to increase in patients who did not outgrow CMA, with no significant difference. The skin-prick test can be used to diagnose CMA and predict CMA outgrowth. A wheal diameter of 8 mm or/and an SI of 1.0 is informative, not only in diagnosing CMA but also in predicting a natural CMA outgrowth.