Monday, 5 December 2011
Poster Hall (Cancún Center)
Cristiane Santos, MD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Claudia Garcia, MD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Ana Paula Beltran Moschione Castro, MD, PhD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Andrea Gushken, MD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Antônio Carlos Pastorino, MD, PhD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Cleonir Beck, MD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Ana Cláudia Brandão, MD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Cristina Miuki Abe Jacob, MD, PhD
,
Department of Pediatrics, Instituto da Criança - Faculdade de Medicina do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
Background: One important point in cow’s milk allergy (CMA) is to stablish predicitve factors in acquiring tolerance. The aim of this study is to evaluate if a ratio of milk components - alpha-lactalbumin (α), beta-lactoglobulin (β), casein (C) and whole milk (WM) can contribute to predict tolerance development.
Methods: It was a retrospective study that included patients with previous diagnosis of CMA evaluated at 6 years old. CMA was defined as a positive double blind placebo-controlled food challenge, open challenge or confirmed anaphylaxis plus positive specific IgE to cow’s milk (higher than 3,5 kU/L or positive skin prick test), and tolerance was defined as acceptance of cow milk without previous symptoms. Specific IgE analysis to WM, α, β, and C were performed through Immunocap® (Phadia AB). Ratios of milk components and whole milk (α /WM , β/WM , C/WM) were calculated and compared the results in two study groups: tolerant and persistent at 6 years old. Since values from both α /WM and β/WM ratios didn’t follow a normal distribution, Mann-Whitney test was used to compare groups. For C/WM ratios Student’s t-test was used, as values were normally distributed.
Results: It was included 49 patients (27 male : 22 female), 24 tolerant and 25 persistent. Average age of Immunocap® test was 2.7 years (SD= 1.4). Comparing the results from two groups, persistent and tolerant it was detected: no difference in α /WM (P=0.055 , Mann-Whitney test), higher levels of β/WM in persistent group (P=0.023 , Mann-Whitney test) and also higher levels of C/WM in persistent group (P=0.004, Student’s t-test).
Conclusions: Higher ratios involving beta-lactoglobulin or casein components were detected in persistent patients. Thus, evaluating these markers precociously can be helpful in predicting CMA evolution.
