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Atopy patch test for early diagnosis of cow's milk allergy in preterm infants

C Dupont1, P Soulaines, A Lapillonne

  • 1Department of Pediatrics-Neonatology, Hôpital Cochin-Saint Vincent de Paul, Université Paris Descartes, France. christophe.dupont@svp.aphp.fr

Journal of Pediatric Gastroenterology and Nutrition
|February 25, 2010
PubMed

Insights

The atopy patch test may aid in the early diagnosis of cow

Area of Science:

  • Pediatric Allergy and Immunology
  • Neonatology
  • Gastroenterology

Background:

  • Cow's milk allergy (CMA) is a common food allergy in infants.
  • Diagnosing CMA in preterm infants presenting with digestive symptoms can be challenging.
  • Traditional diagnostic methods like skin prick tests and IgE may not be sufficiently sensitive in this population.

Purpose of the Study:

  • To evaluate the utility of the atopy patch test (APT) for the early diagnosis of cow's milk allergy in preterm infants with gastrointestinal issues.
  • To compare the efficacy of APT with conventional allergy testing methods.

Main Methods:

  • Retrospective analysis of 14 preterm infants (5 girls, 9 boys) born at a mean gestational age of 31 weeks.
  • Infants presented with digestive symptoms and were assessed for cow's milk allergy.
  • Diagnostic tests included cow's milk skin prick tests, specific immunoglobulin E (IgE) levels, and the atopy patch test (APT).
  • Treatment involved a switch to an amino acid-based formula for infants with suspected CMA.

Main Results:

  • Ten out of 14 infants experienced complete symptom resolution after switching to an amino acid-based formula, suggesting CMA.
  • Cow's milk skin prick tests and specific IgE were negative in all tested infants.
  • The atopy patch test (APT) was positive in 7 of the 10 infants who showed clinical improvement, indicating potential diagnostic value.
  • APT showed higher sensitivity compared to skin prick tests and IgE in this cohort.

Conclusions:

  • The atopy patch test (APT) may serve as a valuable tool for the early diagnosis of cow's milk allergy in preterm infants with digestive symptoms.
  • APT demonstrated potential utility where conventional tests like skin prick tests and IgE were inconclusive.
  • Further prospective studies are warranted to confirm the role of APT in diagnosing food allergies in neonates.

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