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牛奶过敏:可以避免口服食物的挑战吗? 一个基于临床数据的概率分析
María C Díaz1, Pablo Slullitel1, María V Souza1
1Unit of Allergy, Hospital General de Niños "Pedro de Elizalde", City of Buenos Aires, Argentina.
Archivos argentinos de pediatria
|June 21, 2023
概括
识别牛奶蛋白过敏 (CMPA) 可以在没有风险的口服食品挑战的情况下完成. 特定的症状,如血管或包括吐在内的组合,显著增加了CMPA的可能性.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 口服食物挑战 (OFC) 是诊断牛奶蛋白过敏 (CMPA) 的标准,但涉及风险和资源需求.
- 提前识别具有CMPA高概率的患者可以优化诊断途径.
研究的目的:
- 评估临床条件和诊断测试,以确定CMPA的高概率.
- 建立诊断CMPA的标准,而无需使用OFC.
主要方法:
- 从2015年至2018年间诊断或怀疑患有CMPA的239名患者的数据的二次分析.
- 根据症状表现和皮肤刺伤测试和血清IgE水平的结果计算CMPA的测试前和测试后概率.
主要成果:
- 血管作为唯一症状与CMPA的概率>95%有关.
- 疹和吐的组合也表明CMPA的概率>95%.
- 根据特定的切线点,吐与鼻炎的结合,不包括血管,超过了CMPA的95%的概率.
结论:
- 使用临床表现和特定症状组合的诊断方法可以识别具有CMPA高概率的患者.
- 这种方法可以在不需要口服食品挑战的情况下诊断CMPA,从而改善患者安全和资源配置.
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