title: Cow's milk allergy: Evaluating tolerance through skin-prick test.
abstract: To evaluate the wheal diameter in allergy skin-prick tests (SPT) with cow's milk extract (CM) comparing tolerant and persistent patients.
  A retrospective cohort study involving database analysis of children with diagnosis of cow's milk protein allergy (CMPA) mediated by immunoglobulin E in a specialized outpatient clinic that regularly performed SPT between January 2000 and July 2015. Patients were allocated into two groups: tolerant or persistent. Comparisons were made at diagnosis and over time between tolerant and persistent patients using Fisher's, Mann-Whitney or Wilcoxon tests and significance level at 5%.
  After applying inclusion and exclusion criteria, the sample includes 44 patients (29 tolerant and 15 who persisted with CMPA). In the tolerant group, the medians of SPT were: 6 mm at diagnosis and 2 mm at the development of tolerance; a significant difference (p<0.0001) was found. In the persistent group, the median SPT at diagnosis was 7 mm, while in the last SPT it was 5 mm, with no statistical difference (p=0.173). The comparison of medians in the last SPT between groups was significant (p=0.001), with a reduction greater than 50% in SPT in the tolerant group.
  Serial SPTs were useful for diagnosis, and a decrease higher than 50% in diameter can indicate the moment to perform oral food challenge (OFC) tests, helping to detect tolerance in CMPA.
authors.affiliation: MSc from Faculdade de Medicina, Universidade de São Paulo (FMUSP). Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Flavia Valença de Oliveira
authors.initials: FV
authors.lastname: Neves
authors.affiliation: MSc from Faculdade de Medicina, Universidade de São Paulo (FMUSP). Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Cleonir de Moraes Lui
authors.initials: CM
authors.lastname: Beck
authors.affiliation: MSc from Faculdade de Medicina, Universidade de São Paulo (FMUSP). Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Andrea Keiko Fujinami
authors.initials: AK
authors.lastname: Gushken
authors.affiliation: MSc from FMUSP. Division of Nutrition, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil.
authors.forename: Glauce Hiromi
authors.initials: GH
authors.lastname: Yonamine
authors.affiliation: MSc and PhD in Sciences from FMUSP. Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Ana Paula Beltran Moschione
authors.initials: AP
authors.lastname: Castro
authors.affiliation: MSc from Faculdade de Medicina, Universidade de São Paulo (FMUSP). Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Mayra de Barros
authors.initials: MB
authors.lastname: Dorna
authors.affiliation: Assistant, Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Cristiane de Jesus Nunes Dos
authors.initials: CJ
authors.lastname: Santos
authors.affiliation: MSc and PhD in Sciences from FMUSP. Head of the Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Pastorino
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012882:Skin Tests / Q000379:methods*
chemical_list: D007073:Immunoglobulin E