Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.
Universidade do Grande Rio, School of Medicine.
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):e86-e89. doi: 10.1097/MPG.0000000000003031.
This study presents an anamnesis-based questionnaire as a diagnostic tool for cow's milk protein allergy (CMPA) in children. We applied 24 dichotomous yes/no questions to 51 cases diagnosed by oral challenge and 31 controls. All patients were recruited at the pediatric gastroenterologist outpatient practice. Patients with CMPA presented with a family history of atopy/autoimmunity, cesarean delivery, use and/or change of formulas, use of antacids/antibiotics in the first 6 months of life, an overly clean caregiver, multisystem clinical presentation, and the absence of seasonal symptoms. The CMPA group had an average score of 10.4 versus 3.2 for the control group. We identified a cut-off score of 7, which had 94.4% sensitivity and 96.9% specificity to distinguish CMPA from the control population. Cases were younger and showed different symptoms than controls. This study shows the usefulness of an anamnesis-based clinical score to guide the diagnosis of CMPA in children.
本研究提出了一种基于病史的问卷，作为儿童牛奶蛋白过敏（CMPA）的诊断工具。我们对 51 例经口服激发试验诊断的病例和 31 例对照应用了 24 个二分法的是/否问题。所有患者均在儿科胃肠病门诊招募。CMPA 患者具有特应性/自身免疫病史、剖宫产、配方奶使用和/或更换、出生后 6 个月内使用抗酸剂/抗生素、护理人员过分清洁、多系统临床表现和无季节性症状。CMPA 组的平均评分为 10.4，而对照组为 3.2。我们确定了一个 7 的截断值，该值对区分 CMPA 与对照组具有 94.4%的敏感性和 96.9%的特异性。病例组患者年龄更小，且表现出与对照组不同的症状。本研究表明，基于病史的临床评分对于指导儿童 CMPA 的诊断具有一定的作用。
