...continuação e conclusão
38 2 Médio Incompl Normal 2 3 NÃO NÃO 3,0 2,5 5,0
39 6 Médio Compl Cesária 6 9 SIM SIM 3,0 5,5 3,0
40 5 Médio Compl Normal 5 13 SIM SIM 3,0 14,5 8,0 6,0
41 6 Médio Incompl Cesária 6 10 SIM NÃO 3,0 2,5 11,0 8,0 7,0
42 5 Superior Cesária 5 10 SIM SIM 3,5 6,5 7,5
43 4 Médio Compl Cesária 4 8 SIM NÃO 4,0 2,0 5,0 6,0
44 3 Médio Incompl Cesária 3 4 SIM NÃO 3,0 8,0 2,0
47 4 Médio Compl Normal 4 4 SIM NÃO 3,0 5,0 5,5
48 5 Normal 5 SIM SIM 3,0 2,5 9,5 13,0
49 4 Cesária 4 12 SIM NÃO 4,0 2,5 6,5 9,0 9,5
50 2 Cesária 2 21 NÃO NÃO 4,5 3,5 13,5 14,0 5,0
51 6 Cesária 6 12 SIM NÃO 3,5 8,5 8,0
52 1 Normal 1 NÃO NÃO 4,5 4,5 8,5 13,5 3,5
54 4 Cesária 3 14 SIM NÃO 3,5 7,0 6,0
55 4 Cesária 0 3 SIM SIM 4,0 4,0
56 5 Cesária 6 24 SIM SIM 5,0 3,0 8,0 8,5 2,0
57 4 Cesária 4 6 NÃO NÃO 3,0 2,5 3,5
58 2 Cesária 2 12 SIM SIM 3,5 4,5 14,5 9,5 4,5
59 7 Cesária 7 22 NÃO NÃO 3,0 3,0 13,0 14,5 4,5
60 4 Cesária 4 SIM NÃO 3,5 5,5 9,0
61 2 Cesária 0,25 0,75 SIM NÃO 3,0 6,0 13,0 3,5
62 6 Cesária 6 7 SIM NÃO 3,0 4,0 6,5 13,5 4,0
AM: Aleitamento Materno TC: Teste cutâneo
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Abstract
Purpose: The aim of this study was to describe the open oral food challenge applied to
children under three years of age with suspected or previously diagnosed of cow's milk allergy mediated by immunoglobulin E. To analyse the relation between the clinical history and skin prick test results with the results of challenge. Methods: Children aged between five and 36 months, selected to this study based on the suggestive clinical history of immediate reactions to the ingestion of cow's milk and positive skin prick test to cow's milk and/or its protein fractions, underwent open oral food challenge with 100 mL of cow's milk administered in incremental doses (1, 4, 10, 15, 20, 25 and 25 mL) at intervals of 15 to 20 minutes, followed by two hours of observation after the last dose. The test was performed in hospitals by specialists. Results: Forty six children (median age 13.8 months), were evaluated. The oral food challenge was positive in 41.3%. Cutaneous reactions were the most common, observed in 73.7% of the positive challenges, followed by respiratory tract reactions (57.9%) and gastrointestinal reactions (36.8%). According to the severity of the reactions, 57.9%, 36.8% and 5.3% of these children had mild, moderate and severe reactions, respectively. The use of oral antihistamine was sufficient for the remission of signs and symptoms in all positive cases. Regarding the time interval between ingestion of cow's milk and the occurrence of clinical reactions, 68.4% of children with positive challenge showed reactions in the first 20 minutes of test. For most of them (63.2%) intake of 1 mL of cow's milk was enough to elicit symptoms. A higher frequency of positive skin prick test with whole milk and casein was observed in children with positive oral food challenge, with statistically significant difference for those with negative oral food challenge. Conclusions: The method was considered suitable for children up to three years of age, safe and easy to perform. There was significant agreement between the reactions reported by the family history and those observed during the challenge for children with positive results. A positive skin prick test with whole milk and casein was significantly associated with positive results to the oral food challenge.