GP181 Comparing diagnostic tests in children with cow’s milk protein allergy

Introduction Food allergies are very common in the pediatric population; the most common among them is cow’s milk protein allergy (CMPA). The clinical manifestations of this entity are diverse, thus establishing the diagnosis can be challenging. The aim of our human research is to evaluate and compare commonly performed diagnostic tests regarding CMPA. Methods Children with symptoms suggesting cow’s milk protein allergy were included in this study (n=47). The investigation was performed at the Balassa Janos County Hosptital in Szekszard, Hungary. Stool samples were collected from the participating children at the time of the diagnosis, and after 3 months of elimination diet. On the first hospital visit, blood samples were drawn for lymphocyte transformation test (LTT), and a skin allergy test was also performed. On the first and third visit, parents were asked to fill in a questionnaire about the child’s symptoms, which was constructed by the research team. Stool samples were analysed with a fecal calprotectin (FC) rapid test. The lymphocyte transformation tests were conducted in an accredited university laboratory. Skin allergy testing was performed in the hospital setting. Evaluation of the data and the questionnaires was performed with SPSS statistical software. Results In the study population (n=47, mean age:7.36 years, 42.6% female), skin test was performed on 45 subjects; only 2 children (4.44%) showed positive test result for cow’s milk. Positive LTT was observed in 8 children (17%), 4 subjects demonstrated questionable results. Examining the entire research population, no significant difference in fecal calprotectin values was observed before (mean: 73.98 µg/g, SD: 71.12) and after (mean: 68.11 µg/g, SD: 74.04) the elimination diet (p=0.21). However, after dividing the participants into two subgroups according to the questionnaires, the following was observed: a significant decrease in FC values (p Conclusion According to our research data, skin allergy testing and LTT are not reliable diagnostic tools for establishing the diagnosis of CMPA. However, fecal calprotectin can be an objective parameter in confirming the diagnosis of allergic colitis in children with CMPA. Significant improvement in clinical symptoms can only be expected after a strictly followed elimination diet.