IgE-mediated cow's milk allergy in Brazilian children: Outcomes of oral food challenge
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Citações na Scopus
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Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
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ELSEVIER
Autores
BARP, Mariana Fernandes
MARTINS, Tatiana Paskin da Rosa
Citação
WORLD ALLERGY ORGANIZATION JOURNAL, v.16, n.5, article ID 100781, 8p, 2023
Resumo
Background: Oral food challenge (OFC) is useful for diagnosing food allergies and assessing tolerance, but severe reactions may occur during the procedure.Objective: To characterize the frequency and severity of reactions during cow's milk (CM) OFCs.Methods: A cross-sectional study was conducted to analyze the outcome of cow's milk oral food challenges (CMOFCs) performed to confirm IgE-mediated CM allergy or to assess food tolerance. CM was given first as baked milk (BM), followed by whole CM if there was no prior reaction to BM. An OFC was considered positive if IgE-mediated symptoms developed up to 2 h after ingestion. Symptoms were described and variables including age at OFC, prior anaphylaxis, other atopic diseases, and skin test results were compared according to the OFC outcomes.Results: A total of 266 CMOFCs were performed, including 159 patients with a median age of 6.3 years old. One hundred thirty-six tests were positive and 62 resulted in anaphylaxis. Thirty-nine anaphylactic reactions were observed up to 30 min after the first dose. Severe anaphylaxis (car-diovascular and/or neurological involvement) was reported in 5 tests. A second dose of epinephrine was required in 3 tests, and 1 presented a biphasic response. Younger patients had a higher risk of anaphylaxis during baked milk oral food challenge (BMOFC) (p = 0.009). The fre-quency of anaphylaxis was higher in patients submitted to BM (p = 0.009).Conclusions: Anaphylaxis is a known complication of CMOFCs even when there is no prior anaphylaxis or when conducted with baked products. This study reinforces the importance of conducting OFC in appropriate settings with a well-trained team.
Palavras-chave
Milk allergy, Immunotherapy, Anaphylaxis, Epinephrine, Children, Adolescent
Referências
- Abrams EM, 2017, ALLERGY ASTHMA CL IM, V13, DOI 10.1186/s13223-017-0215-8
- Ahrens B, 2014, CLIN EXP ALLERGY, V44, P572, DOI 10.1111/cea.12284
- Ahrens B, 2012, J ALLERGY CLIN IMMUN, V130, P549, DOI 10.1016/j.jaci.2012.05.045
- Akuete K, 2017, ANN ALLERGY ASTHMA I, V119, P1
- Barbosa CPG, 2017, ALLERGOL IMMUNOPATH, V45, P283, DOI 10.1016/j.aller.2016.10.008
- Bird JA, 2020, J ALLERGY CLIN IMMUN, V8, P17
- Bock SA, 2001, J ALLERGY CLIN IMMUN, V107, P191, DOI 10.1067/mai.2001.112031
- Brown SGA, 2013, J ALLERGY CLIN IMMUN, V132, P1141, DOI 10.1016/j.jaci.2013.06.015
- Campbell RL, 2015, J ALLER CL IMM-PRACT, V3, P576, DOI 10.1016/j.jaip.2015.04.009
- Capucilli P, 2018, ANN ALLERG ASTHMA IM, V121, P580, DOI 10.1016/j.anai.2018.07.018
- Castro AP, 2015, ALLERGOL IMMUNOPATH, V43, P67, DOI 10.1016/j.aller.2013.09.012
- Cox AL, 2018, CURR ALLERGY ASTHM R, V18, DOI 10.1007/s11882-018-0825-3
- Cuomo B, 2017, ITAL J PEDIATR, V43, DOI 10.1186/s13052-017-0410-8
- Dang AT, 2020, WORLD ALLERGY ORGAN, V13, DOI 10.1016/j.waojou.2020.100100
- Neves FVD, 2016, REV ASSOC MED BRAS, V62, P537, DOI 10.1590/1806-9282.62.06.537
- DunnGalvin A, 2013, J ALLERGY CLIN IMMUN, V131, P230, DOI 10.1016/j.jaci.2012.08.051
- DunnGalvin A, 2011, J ALLERGY CLIN IMMUN, V127, P633, DOI 10.1016/j.jaci.2010.12.004
- Flom JD, 2019, NUTRIENTS, V11, DOI 10.3390/nu11051051
- Gupta RS, 2011, PEDIATRICS, V128, pE9, DOI 10.1542/peds.2011-0204
- Gushken AKF, 2013, ALLERGOL IMMUNOPATH, V41, P94, DOI 10.1016/j.aller.2011.12.002
- Heinzerling Lucie, 2013, Clin Transl Allergy, V3, P3, DOI 10.1186/2045-7022-3-3
- Horimukai K, 2015, ALLERGY, V70, P334, DOI 10.1111/all.12562
- Jarvinen KM, 2008, J ALLERGY CLIN IMMUN, V122, P133, DOI 10.1016/j.jaci.2008.04.031
- Jarvinen KM, 2009, J ALLERGY CLIN IMMUN, V124, P1267, DOI 10.1016/j.jaci.2009.10.006
- Kawahara T, 2019, EUR J PEDIATR, V178, P181, DOI 10.1007/s00431-018-3274-z
- Lee J, 2013, ALLERGY ASTHMA PROC, V34, P220, DOI 10.2500/aap.2013.34.3669
- Leonard SA, 2015, J ALLER CL IMM-PRACT, V3, P13, DOI 10.1016/j.jaip.2014.10.001
- Lieberman JA, 2011, J ALLERGY CLIN IMMUN, V128, P1120, DOI 10.1016/j.jaci.2011.07.012
- Mankad VS, 2008, ANN ALLERG ASTHMA IM, V100, P469, DOI 10.1016/S1081-1206(10)60473-5
- Noone S, 2015, J ALLER CL IMM-PRACT, V3, P424, DOI 10.1016/j.jaip.2014.10.008
- Nowak-Wegrzyn A, 2008, J ALLERGY CLIN IMMUN, V122, P342, DOI 10.1016/j.jaci.2008.05.043
- Nowak-Wegrzyn A, 2018, J ALLER CL IMM-PRACT, V6, P486, DOI 10.1016/j.jaip.2017.10.021
- Pepys J, 1975, BRIT J HOSP MED, V14, P412
- Perry TT, 2004, J ALLERGY CLIN IMMUN, V114, P1164, DOI 10.1016/j.jaci.2004.07.063
- Perry TT, 2004, J ALLERGY CLIN IMMUN, V114, P144, DOI 10.1016/j.jaci.2004.04.009
- Rolinck-Werninghaus C, 2012, ALLERGY, V67, P951, DOI 10.1111/j.1398-9995.2012.02838.x
- Rona RJ, 2007, J ALLERGY CLIN IMMUN, V120, P638, DOI 10.1016/j.jaci.2007.05.026
- Sampson HA, 2003, PEDIATRICS, V111, P1601
- SAMPSON HA, 1992, NEW ENGL J MED, V327, P380, DOI 10.1056/NEJM199208063270603
- Sampson Hugh A, 2006, J Allergy Clin Immunol, V117, P391, DOI 10.1016/j.jaci.2005.12.1303
- Schoemaker AA, 2015, ALLERGY, V70, P963, DOI 10.1111/all.12630
- Sicherer SH, 2018, J ALLERGY CLIN IMMUN, V141, P41, DOI 10.1016/j.jaci.2017.11.003
- Spergel JM, 2004, ANN ALLERG ASTHMA IM, V92, P217, DOI 10.1016/S1081-1206(10)61550-5
- Sporik R, 2000, CLIN EXP ALLERGY, V30, P1540, DOI 10.1046/j.1365-2222.2000.00928.x
- Sugiura S, 2017, ALLERGOL INT, V66, P493, DOI 10.1016/j.alit.2016.11.005
- Tsuang A, 2018, ANN ALLERG ASTHMA IM, V121, P469, DOI 10.1016/j.anai.2018.06.015
- Vitalpur G, 2016, ALLERGY ASTHMA CL IM, V12, DOI 10.1186/s13223-016-0125-1
- Wainstein BK, 2010, PEDIAT ALLERG IMM-UK, V21, P603, DOI 10.1111/j.1399-3038.2010.01063.x
- Wang J, 2016, ALLERGY ASTHMA PROC, V37, P439, DOI 10.2500/aap.2016.37.3997
- Yanagida N, 2018, PEDIAT ALLERG IMM-UK, V29, P417, DOI 10.1111/pai.12896
- Yanagida N, 2017, INT ARCH ALLERGY IMM, V172, P173, DOI 10.1159/000458724
- Yanagida N, 2017, INT ARCH ALLERGY IMM, V172, P116, DOI 10.1159/000456008