Non-IgE-mediated cow milk allergy is linked to early childhood clusters of commonly seen illnesses: a pilot study.
OBJECTIVE
There are few established diagnostic tools to define non-IgE-mediated food hypersensitivity reactions. Cow milk protein allergy (CMPA) is a multisystem disorder affecting the gastrointestinal, skin, and lower and upper airway systems. This link is frequently missed because of subspecialty evaluation of the multisystem effects individually. The authors hypothesize that a more global evaluation based on a simple scored questionnaire will reveal this link.


METHODS
Over an 18-month period, children younger than 2 years with non-IgE-mediated CMPA were identified. A symptom questionnaire was developed and scored and also applied to a control population. The prevalence of symptoms in each group was compared and a cumulative score was determined. Symptoms evaluated included gastrointestinal, aerodigestive, lower airway, and skin symptoms. A positive response was scored 1 and a negative response scored 0.


RESULTS
Significant differences in prevalence rates between CMPA and control populations were noted, particularly in aerodigestive symptoms. There were marked differences in cumulative score between populations (P < .001). The authors identified a cut-off score at which there was close to 80% sensitivity and 90% specificity for distinguishing CMPA from a control population.


CONCLUSIONS
A global evaluation of multiple systems can be an important diagnostic tool in determining CMPA in infants.
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA. gibbonstroye@uams.edu
Troy E
TE
Gibbons
Sowmya N
SN
Patil
Juliana C
JC
Frem
Chandra
C
Smith
Josephine
J
Wakwe
Christopher J
CJ
Swearingen
D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D010865:Pilot Projects; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D007073:Immunoglobulin E