Vanto Timo, Helppilä Sinikka, Juntunen-Backman Kaisu, Kalimo Kirsti, Klemola Timo, Korpela Riitta, Koskinen Pertti
Department of Pediatrics, Turku University Hospital, Turku, Finland.
J Pediatr. 2004 Feb;144(2):218-22. doi: 10.1016/j.jpeds.2003.10.063.
To investigate whether the development of tolerance to cow's milk (CM) by aged 4 years can be predicted with a skin prick test (SPT) and measurements of total or specific immunoglobulin E (IgE) in the serum, taken at the time of diagnosis of cow's milk hypersensitivity (CMH).
Infants with immediate (n=95) or delayed (n=67) challenge reactions to CM were prospectively followed to aged 4 years. CMH status was assessed annually by CM challenges.
By aged 2, 3, and 4 years, children with delayed reactions developed tolerance to CM faster than those with immediate reactions: 64%, 92%, and 96% versus 31%, 53%, and 63%, respectively. A wheal size of <5 mm in SPT correctly identified 83% of 124 infants who developed tolerance to CM by aged 4 years, and a wheal size of >or=5 mm in SPT correctly identified 71% of 39 infants with persistent CMH. Milk-specific IgE <2 kU/L correctly identified 82% of infants who developed tolerance to CM, and milk-specific IgE >or=2 kU/L correctly identified 71% of infants with persistent CMH.
SPT and milk-specific IgE in the serum are useful prognostic indicators of the development of tolerance to CM in infants with CMH.
研究在牛奶过敏（CMH）诊断时进行的皮肤点刺试验（SPT）以及血清总免疫球蛋白E（IgE）或特异性IgE的检测，能否预测4岁时对牛奶（CM）耐受性的发展情况。
对牛奶速发反应（n = 95）或迟发反应（n = 67）的婴儿进行前瞻性随访至4岁。每年通过牛奶激发试验评估CMH状态。
到2岁、3岁和4岁时，迟发反应的儿童比速发反应的儿童对CM产生耐受性的速度更快：分别为64%、92%和96%，而速发反应儿童相应比例为31%、53%和63%。皮肤点刺试验风团大小<5mm可正确识别124名4岁时对CM产生耐受性婴儿中的83%，皮肤点刺试验风团大小≥5mm可正确识别39名持续存在CMH婴儿中的71%。牛奶特异性IgE<2kU/L可正确识别82%对CM产生耐受性的婴儿，牛奶特异性IgE≥2kU/L可正确识别71%持续存在CMH的婴儿。
血清中的皮肤点刺试验和牛奶特异性IgE是CMH婴儿对CM耐受性发展的有用预后指标。
