title: Atopy patch tests are useful to predict oral tolerance in children with gastrointestinal symptoms related to non-IgE-mediated cow's milk allergy.
abstract: Atopy patch tests (APTs) have been proposed for the diagnostic approach in children with non-IgE-mediated cow's milk allergy and gastrointestinal symptoms. We aimed to investigate the benefit of APTs in predicting oral tolerance in these patients. We prospectively evaluated 172 subjects with a sure diagnosis of non-IgE-mediated CMA and gastrointestinal symptoms (97 boys, 56.4%; age, 6.37 m; range, 2-12 m). At diagnosis, 113/172 (65.7%) children had positive APTs to cow's milk proteins (CMP). After 12 months of exclusion, diet APTs were repeated immediately before OFC. APTs significantly correlated (P < 0.001) with the OFC outcome (r 0.579). Diagnostic accuracy was sensitivity of 67.95%, specificity of 88.3%, PPV of 82.81%, NPV of 76.85%, and a +LR of 5.80. APTs are a valuable tool in the follow-up of children with non-IgE-mediated CMA-related gastrointestinal symptoms by contributing in determining whether an OFC can safely be undertaken.
authors.affiliation: Department of Pediatrics, University of Naples Federico II, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Nocerino
authors.forename: V
authors.initials: V
authors.lastname: Granata
authors.forename: M
authors.initials: M
authors.lastname: Di Costanzo
authors.forename: V
authors.initials: V
authors.lastname: Pezzella
authors.forename: L
authors.initials: L
authors.lastname: Leone
authors.forename: A
authors.initials: A
authors.lastname: Passariello
authors.forename: G
authors.initials: G
authors.lastname: Terrin
authors.forename: R
authors.initials: R
authors.lastname: Troncone
authors.forename: R
authors.initials: R
authors.lastname: Berni Canani
mesh_terms: D000367:Age Factors; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007108:Immune Tolerance; D007073:Immunoglobulin E / Q000276:immunology / Q000378:metabolism; D007223:Infant; D008297:Male; D008892:Milk / Q000009:adverse effects*; D016269:Milk Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D008894:Milk Proteins; D010328:Patch Tests / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D008894:Milk Proteins; D007073:Immunoglobulin E