Study on the family open oral food challenge in infants with non-IgE mediated cow'smilk protein allergy

XIONG Li-jing; HE Xiao-qing; LI Jing; LI Yang; YANG Wen-xu; LIU Li-rong; XIE Xiao-li

doi:10.11852/zgetbjzz2021-0357

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Chinese Journal of Child Health Care ›› 2021, Vol. 29 ›› Issue (6) : 689-693. DOI: 10.11852/zgetbjzz2021-0357

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Study on the family open oral food challenge in infants with non-IgE mediated cow'smilk protein allergy

XIONG Li-jing^*, HE Xiao-qing, LI Jing, LI Yang, YANG Wen-xu, LIU Li-rong, XIE Xiao-li

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Abstract

Objective To evaluate outcome interpretation of family open oral food challenge(OFC) utilized in infants who could not be confirmed by CMP-specific IgE and skin prick tests,in order to improve the accuracy of parent-reported symptoms. Methods A prospective study was conducted to enroll infants who took open OFCs from November 2018 to June 2019. The diagnosis efficiency and the accuracy of parent-reported symptoms were analyzed. Results A total of 162 infants received OFC for diagnosis,with an average age of(5.85±3.03)months old.While OFCs were conducted in 142 infants [(8.10±3.08) months old] for the judgment of oral tolerance.No episodes of anaphylaxis occurred in the process of challenge.Cutaneous and gastrointestinal symptoms were commonly reported on the first day of the test(77.78%) and the first week(79.58%).Kappa coefficient was 0.868(P＜0.001),suggesting good consistency of judgments between parents and specialists.The diagnosis accuracy of family open OFC tesx was 93.43%.The false-positive rate,false-negative rate,positive predictive value,negative predictive value was 9.15%,4.32%,90.85% and 95.68%,respectively.Vomiting was the most frequent reactions reported in false-positive cases.The amount of stimulation formula and the observation time were the important factors accounting for the false-negative results. Conclusions Family open OFC is an accurate and safe tool for assessing oral tolerance status in CMPA infants.The detailed instruction for parents and identification of the reproducibility could increase the safety and reliability of open OFC performing at home.

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open oral food challenge / cow's milk protein allergy / non-IgE mediated / infants

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XIONG Li-jing, HE Xiao-qing, LI Jing, LI Yang, YANG Wen-xu, LIU Li-rong, XIE Xiao-li. Study on the family open oral food challenge in infants with non-IgE mediated cow'smilk protein allergy[J]. Chinese Journal of Child Health Care. 2021, 29(6): 689-693 https://doi.org/10.11852/zgetbjzz2021-0357

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