García-Ara M C, Boyano M T, Díaz-Pena J M, Quirce S
Servicio de Alergia, Hospital Infantil Universitario La Paz, Madrid, Spain.
Allergol Immunopathol (Madr). 2008 Nov-Dec;36(6):315-9. doi: 10.1016/s0301-0546(08)75862-2.
Ingestion of small amounts of cow's milk (CM) can elicit adverse reactions in patients with IgE-mediated CM allergy. Knowing the dose eliciting allergic reactions and the factors affecting it can be of great help in avoiding these reactions.
To analyse the eliciting doses of positive challenge test in patients with CM allergy and to determine its association with the level of CM specific IgE.
Ninety-eight positive challenge tests in 56 children, median age of 11 months (3-80) with IgE-mediated CM allergy were retrospectively analysed. Open oral challenge tests were carried out by gradually increasing doses of milk (2-100 ml). The relationship between challenge test doses and CM specific IgE levels were studied.
18 % of the challenge tests were positive with 2 ml, 24 % with doses between 5 and 10 ml, and the other 58 % with doses between 25 and 100 ml. An inverse association between the doses of the positive challenge test and the level of CM specific- IgE was found, 13.9 kU/L (0.54-> 100 kU/L) when the challenge test was positive with the smaller dose (2 ml); and 1.73 kU/L (< 0.35-76.4 kU/L) with doses above 2 ml (p = 0.0001). The median age of the patients was 13 months (6-49) when the challenge test was positive with 2 ml vs 9 months (3-80) with doses above 2 ml (p = 0.048).
The CM specific IgE level and patient's age should be considered in the assessment of the eliciting doses of positive challenge test in CM allergy.
摄入少量牛奶（CM）可引发IgE介导的牛奶过敏患者的不良反应。了解引发过敏反应的剂量及其影响因素有助于避免这些反应。
分析牛奶过敏患者阳性激发试验的激发剂量，并确定其与牛奶特异性IgE水平的关联。
回顾性分析56例年龄中位数为11个月（3 - 80个月）的IgE介导的牛奶过敏儿童的98次阳性激发试验。通过逐渐增加牛奶剂量（2 - 100毫升）进行开放性口服激发试验。研究激发试验剂量与牛奶特异性IgE水平之间的关系。
18%的激发试验在2毫升时呈阳性，24%在5至10毫升之间呈阳性，另外58%在25至100毫升之间呈阳性。发现阳性激发试验的剂量与牛奶特异性IgE水平呈负相关，当较小剂量（2毫升）激发试验呈阳性时为13.9 kU/L（0.54 -> 100 kU/L）；剂量高于2毫升时为1.73 kU/L（< 0.35 - 76.4 kU/L）（p = 0.0001）。激发试验在2毫升时呈阳性的患者年龄中位数为13个月（6 - 49个月），而剂量高于2毫升时为9个月（3 - 80个月）（p = 0.048）。
在评估牛奶过敏阳性激发试验的激发剂量时，应考虑牛奶特异性IgE水平和患者年龄。
