Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco, Recife, PE, Brazil.
J Pediatr (Rio J). 2010 Jul-Aug;86(4):285-9. doi: 10.2223/JPED.2011. Epub 2010 May 27.
To determine the prevalence of cow's milk protein allergy in children with symptoms attributed to cow's milk intake.
Sixty-five children with symptoms attributed to cow's milk intake were studied. Diagnosis was established after an open oral food challenge test carried out at least 15 days after an elimination diet and absence of symptoms, with a follow-up period of up to 4 weeks after the test. The children who remained asymptomatic after this period were considered negative for cow's milk protein allergy (n = 30), while those whose symptoms reappeared were considered positive (n = 35).
The median age was 5 months (P 25-75% 2-9 months) in the case group and 7 months (P 25-75% 4-11 months) in the comparison group (p = 0.05). The test did not confirm cow's milk protein allergy in 46.8% of the patients with symptoms attributed to cow's milk intake. A delayed reaction occurred in 77.1% (27/35) of the cases testing positive, 18/27 in the first week, 3/27 in the second week, and 6/27 in the third week of follow-up. A statistically significant association was found between cutaneous manifestations and positive test result (p = 0.04). However, there was no association with digestive and respiratory symptoms.
Our results confirm the need of an oral food challenge test to determine which patients really have cow's milk protein allergy and may therefore benefit from a diet free of cow's milk.
确定有牛奶摄入症状的儿童中牛奶蛋白过敏的患病率。
研究了 65 例有牛奶摄入症状的儿童。在消除饮食和无症状至少 15 天后进行开放口服食物挑战试验，且在试验后 4 周内进行随访，从而建立诊断。在此期间无症状的儿童被认为对牛奶蛋白过敏呈阴性（n=30），而症状再次出现的儿童被认为呈阳性（n=35）。
病例组的中位年龄为 5 个月（P25-P75：2-9 个月），对照组为 7 个月（P25-P75：4-11 个月）（p=0.05）。该试验未在 46.8%的有牛奶摄入症状的患者中确认牛奶蛋白过敏。77.1%（27/35）的阳性病例出现迟发反应，其中 18/27 例在第一周，3/27 例在第二周，6/27 例在第三周的随访中出现反应。阳性试验结果与皮肤表现之间存在统计学显著关联（p=0.04）。然而，与消化系统和呼吸系统症状之间没有关联。
我们的结果证实需要进行口服食物挑战试验，以确定哪些患者确实患有牛奶蛋白过敏，从而可以从不含牛奶的饮食中受益。
