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Ovid: P0495 ATOPY PATCH TESTS, A NEW TOOL FOR DIAGNOSIS OF D

Journal of Pediatric Gastroenterolog and Nutrition Issue: Volume 39 Supplement 1, June 2004, pp S244-S245 Copyright: 2004 Lippincott Williams & Wilkins, Inc. Publication Type: [ABSTRACTS: Poster Session Abstracts] ISSN: 0277-2116 Accession: 00005176-200406001-00619 [ABSTRACTS: Poster Session Abstracts]

P0495 ATOPY PATCH TESTS, A NEW TOOL FOR DIAGNOSIS OF DIGESTIVE COW S MILK ALLERGY
Dupont, C.1; De Boissieu, D.1

Author Information
1Neonatolog , Hospital Saint Vincent de Paul, PARIS, France

Submitted by: christophe.dupont@svp.ap-hop-paris.fr Introduction: Diagnosis of cow s milk allergy (CM A) in the presence of chronic digestive symptoms is based on the results of an elimination diet followed by a provocation test. Skin prick tests and IgE antibodies are generally negative. The atopy patch tests (APT) has been shown to be useful in suspected delayed reactions to allergens. The aim of the study was to provide an approach to the accuracy of the APT in the diagnosis of CM PA in patients with digestive symptoms and a negative prick test.

Methods: Patients: 73 infants, 42M , aged 18 + 23 months, were referred for exploration of digestive symptoms (GER = 38, diarrhea = 38, colic = 27, constipation = 4, difficult feeding = 6) and /or failure to thrive (n=20) with suspected CM A. All infants underwent an cow s milk APT. Diagnosis of CM A was retained if symptoms disappeared during elimination and relapsed during provocation with milk.

Results: 54 infants were allergic to cow s milk (CM A) and 19 were not (non-CM A). APTs were positive in 35 children (65%) of CM A group versus 1 of 19 (5%) children of the non-CM A group (p < 0.001). Cow s milk specific IgE were positive in 3 of CM A group at very low levels (<0.6KUI/L).

Conclusion: We report 65% positivity of patch testing in children with CM A and gastrointestinal symptoms, contrasting with 5% positivity in the control group. A large use of the APT in the presence of chronic digestive symptoms could improve detection of conditions related to CM A. A standardization of the technique seems to be mandatory.

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