Adaptation of the double blind placebo controlled oral food challenge for the cows milk allergy diagnosis mediated by immunoglobulin E, in pediatric age / Adaptação do teste de provocação oral duplo cego placebo controlado para o diagnóstico de alergia às proteínas do leite de vaca mediada pela imunoglobulina E, na faixa etária pediátrica

AUTOR(ES)

Andrea Keiko Fujinami Gushken

DATA DE PUBLICAÇÃO

2009

RESUMO

The Double Blind Placebo Controlled Food Challenge (DBPCFC) is considered an important method for food allergy diagnosis, nevertheless it is not standardized among us. The aim of this study was to adapt DBPCFC for cows milk allergy (CMA) diagnosis in children and adolescents. A secondary aim was to describe the relation between history of atopy and laboratorial findings with DBPCFC results. It was included 58 patients that were distributed in two groups. Group 1 was composed of 39 patients (median age: 5,3 years; 1,6M:1F) with suggestive history of CMA without recent anaphylaxis, and specific IgE to cow´s milk (CM) and/or its fractions. In group 2 was included 19 patients (median age 8,3 years; 1,4 M:1F) where the CMA diagnosis was excluded based on clinical findings. The items evaluated in the adaptation of this method were: setting choice, kind of milk processing and vehicles, besides material and test performance. Day hospital was considered adequate for this test. Regarding to elected materials to offer the vehicle, opaque and sealed recipients showed more suitable to test demands. Vehicles more accepted were legumes soup and soy beverage and the most adequate CM to be offered was liquid and with low lactose concentration. The difficult observed in performance of DBPCFC do not compromise its execution, however the interpretation of the results was very difficult specially in patients with perioral wheals and unspecific clinical findings. There is an agreement Comparing adopted clinical and laboratorial criterion for definition of group 1 and 2 with DBPCFC results. In conclusion, the test proved to be feasible and safe and its adaptation is possible for IgE mediated CMA diagnosis, being necessary to evaluate its reproducibility in other populations.

ASSUNTO(S)

food hypersensitivity/diagnosis adolescent adolescente leite de vaca hipersensibilidade alimentar/diagnóstico methodology criança cows milk metodologia child

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