title: Practical interest of both skin prick test and specific IgE in the evaluation of tolerance acquisition in IgE mediated cow's milk allergy (CMA). A clinical retrospective study in a cohort of 184 children.
abstract: BACKGROUND
  Cow's milk protein allergy (CMPA) represents one of the leading causes of food allergy in infants and young children. The immune reaction may be IgE mediated, non-IgE mediated, or mixed. IgE-mediated cow's milk protein allergy is revealed by immediate and acute symptoms which can be severe. The aim of this study is to report a one centre experience in the real life of testing children with IgE-mediated CMPA and try to identify predictive factor for follow-up challenges.
  
  
  METHODS
  Retrospective and monocentric study between September 1997 and February 2008. 178 infants diagnosed with IgE-mediated CMPA during breastfeeding weaning were included. Initial factors such as age, sex, skin prick tests (SPTs), specific IgE (sIgE), atopic dermatitis and types of reaction were noted. Between 12 and 24 months all infants have undergone at least one evaluation including SPT.
  
  
  RESULTS
  At the food challenge, 138 (75.8%) infants were found tolerant. Results of the skin prick test (SPT) were statistically different according to the food challenge result (2.2mm vs. 5.1mm, p<0.0001). It was the same result for sIgE for CM 2.0ku/l vs. 11.5ku/l - p<0.0001 and for casein 1.0ku/l vs. 16.0ku/l - p=0.0014.
  
  
  CONCLUSIONS
  This study confirms the practical interest of both SPT and sIgE in the evaluation of tolerance induction in IgE-mediated CMPA, but with no corresponding results. Sensitivity, specificity and probability curves of success for cow's milk challenge can be determined and have clinical utility.
authors.affiliation: Hospices Civils de Lyon, Lyon 1 University, Allergology Unit, Department of Pediatrics, HFME Children's Hospital of Lyon, CHU de Lyon, 59 bvd Pinel, 69677 Bron, France.
authors.forename: F
authors.initials: F
authors.lastname: Payot
authors.affiliation: Hôpital Louis Pradel, EPICIME-INSERM CIC201, 28, Avenue du Doyen Lépine, 69677 cedex, Bron, France; Université Lyon 1, Equipe d'Accueil 4129, France; CHU Lyon, Service de Pharmacologie Clinique, 8 rue Guillaume Paradin, BP8071, 69376 cedex 08, Lyon, France. Electronic address: Julien.berthiller@chu-lyon.fr.
authors.forename: J
authors.initials: J
authors.lastname: Berthiller
authors.affiliation: CHU Lyon, Service de Pharmacologie Clinique, 8 rue Guillaume Paradin, BP8071, 69376 cedex 08, Lyon, France; University of Lyon 1, CRNS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive Lyon, 8 rue Guillaume Paradin, BP8071, 69376 cedex 08, Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Kassai
authors.affiliation: Hospices Civils de Lyon, Lyon 1 University, Allergology Unit, Department of Pediatrics, HFME Children's Hospital of Lyon, CHU de Lyon, 59 bvd Pinel, 69677 Bron, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Brunet
authors.affiliation: Hospices Civils de Lyon, Lyon 1 University, Allergology Unit, Department of Pediatrics, HFME Children's Hospital of Lyon, CHU de Lyon, 59 bvd Pinel, 69677 Bron, France.
authors.forename: F
authors.initials: F
authors.lastname: Villard-Truc
authors.affiliation: Hospices Civils de Lyon, Lyon 1 University, Allergology Unit, Department of Pediatrics, HFME Children's Hospital of Lyon, CHU de Lyon, 59 bvd Pinel, 69677 Bron, France.
authors.forename: A
authors.initials: A
authors.lastname: Lachaux
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D012189:Retrospective Studies; D012882:Skin Tests
chemical_list: D007073:Immunoglobulin E
keywords: Cow's milk protein allergy; IgE-mediated; Skin prick test; Specific IgE