Comparison of allergen extract with various milk products of Skin Prick tests in diagnosing cow's milk allergy

INTRODUCTION AND OBJECTIVE: Food allergy is the sum of events happening as a result of a process in immune system after a nutrient enters the system. In this study, we have tried to solve the incompatibilities between skin prick test (SPT) and clinical picture encountered among patients after SPT. Thus we used various milk products (raw, UHT and pasteurized cow's milk) with milk allergen extract for patients for whom we think cow's milk protein allergy (CMPA) due to the low positive predictive value of SPT and made a comparison between them. MATERIALS AND METHODS: This study was carried out prospectively on 79 patients in Sakarya University Medical Faculty Pediatric Immunology and Allergy Clinic between 01.02.2019 and 01.06.2019. RESULTS: In our study, the rate of skin reaction against fresh milk was found to be statistically significantly higher in the group with specific Ig E positive against cow's milk and its other components (casein, beta-lactoglobulin), except for alpha-lactalbumin. This finding suggests that the use of fresh milk can yield more accurate results in the detection of cow's milk allergy in clinical practice. The area under the curve for the diagnostic value of fresh milk is 93.1%. For the cutoff value of 2.50 mm, 88.1% sensitivity (sensitivity) and 90.8% specificity (specificity) were determined. An increase of 1 mm in the fresh milk reaction area increases the probability of allergy by 3.36 times. It was determined that the presence of erythema increased the risk of allergy 93 times compared to urticaria, and the presence of eczema increased the risk of allergy 140 times compared to urticaria. CONCLUSION: The number of studies on milk products and their utulization with skin prick test extracts used in diagnosis of cow milk allergy are limited in literature, so further research is required. Key Words: Cow's milk protein allergy, SPT