Schrander J J, Dellevoet J J, Arends J W, Forget P P, Kuijten R
Department of Pediatrics, Academic Hospital Maastricht, The Netherlands.
Ann Allergy. 1993 May;70(5):406-9.
In a prospective study we looked for the presence of both IgE plasma cells in small bowel mucosa and specific serum IgE antibodies to cow milk in children suspected of cow milk protein intolerance. Thirty-one children with complaints possibly due to cow milk intolerance were submitted to two consecutive cow milk elimination/challenge tests. The diagnosis of cow milk protein intolerance was confirmed in 16 of our 31 patients on the basis of two positive elimination/challenge tests. IgE plasma cells were found in nine of 16 patients with proven cow milk protein intolerance and in only one of the 15 patients without cow milk protein intolerance (p < .01). The RAST for cow milk was positive in six of 16 infants with cow milk protein intolerance and in two of the 15 other infants. Serum IgE level was of no value for the diagnosis of cow milk protein intolerance. Neither of these diagnostic procedures was sensitive enough to be used as a screening test for cow milk protein intolerance. Furthermore, the relationship between specific IgE antibodies for cow milk and the presence of mucosal IgE plasma cells was poor: five of nine infants with cow milk protein intolerance and the presence of mucosal IgE plasma cells had negative RASTs for cow milk.
在一项前瞻性研究中，我们在怀疑患有牛奶蛋白不耐受的儿童中，寻找小肠黏膜中IgE浆细胞以及针对牛奶的特异性血清IgE抗体的存在情况。31名可能因牛奶不耐受而出现症状的儿童接受了连续两次牛奶排除/激发试验。在我们的31例患者中，有16例根据两次阳性排除/激发试验确诊为牛奶蛋白不耐受。在16例经证实患有牛奶蛋白不耐受的患者中，有9例发现了IgE浆细胞，而在15例无牛奶蛋白不耐受的患者中仅1例发现了IgE浆细胞（p<0.01）。16例牛奶蛋白不耐受婴儿中有6例牛奶RAST检测呈阳性，其他15例婴儿中有2例呈阳性。血清IgE水平对牛奶蛋白不耐受的诊断无价值。这些诊断方法均不够敏感，不足以用作牛奶蛋白不耐受的筛查试验。此外，针对牛奶的特异性IgE抗体与黏膜IgE浆细胞的存在之间的关系不佳：9例牛奶蛋白不耐受且存在黏膜IgE浆细胞的婴儿中有5例牛奶RAST检测呈阴性。
