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Dorota Karol, Maciej Kaczmarski
Med Sci Monit 1999; 5(3): CR502-509
The work was an attempt to evaluate the usefulness of in vivo (oral challenge tests, prick tests) and in vitro tests (IgEc, IgEs, eosinophilia in blood) used on routine basis in the diagnostics of hypersensitivity to cow's milk proteins. A group of 180 children was selected (114 boys and 66 girls aged 2 months 12 years) whose both medical history and the nature of clinical symptoms indicated hypersensitivity to cowąs milk proteins, confirmed by positive result of elimination test and an open oral challenge with this food. IgEc exceeded normal range for particular age group in 51 children (28.3%). Specific antibodies against cowąs milk proteins were observed in 21/27 patients, while positive skin reactions (prick-tests) were obtained in 9 (5%) children. In 49 (27%) children, there was an increase of the absolute number of eosinophils in blood. Oral challenge with cowąs milk (in the case of negative results of additional investigations) was a decisive test confirming the diagnosis in 155 (86%) children. Positive correlation between clinical symptoms and oral challenge test with cowąs milk as well as skin tests and the presence of IgE specific antibodies was observed only in 5 children. In 16 patients, the diagnosis was established on the basis of positive result of oral challenge tests and the presence of trophic antibodies in blood serum, while in the case of 4 children, the diagnosis was based on positive results of oral load tests and skin tests.