Are There Symptoms and Signs Related to a Positive Oral Cow's Milk Challenge in Brazilian Suspected Children?

U E S D A Y 813 Are There Symptoms and Signs Related to a Positive Oral Cow's Milk Challenge in Brazilian Suspected Children? Ana Carolina Rozalem, MD, Renata R. Cocco, Lucila Camargo, MD, Marcia Mallozi, MD, Dirceu Sole, MD, PhD, FAAAAI; Federal University of Sao Paulo, Sao Paulo, Brazil, Federal University of S~ao Paulo, UNIFESP, S~ao Paulo, Brazil, Federal University of S~ao Paulo, S~ao Paulo, Brazil. RATIONALE: Cow’sMilk (CM) is the main cause of food allergy (FA) in children. The aim of this study was searching for main symptoms that could predict a positive CM food challenge (CMFC). METHODS: 154 Children with suspected CM allergy (CMA) were undergone to 175 CMFC and comprised 2 groups according to the result: negative test (NG, n5132) and positive test (PG, n540). Both groups were analyzed regarding to age at first reaction, gender, nutritional status, breastfeeding, familial history of FA, symptoms reported, presence of atopic diseases and results of skin prick test (SPT). PG was analyzed according to required amount of CM to react, symptoms and severity of reaction. RESULTS: Comparing groups, PG was significantly associated with patient’s reports of urticaria (77.5%x42.4%, OR54.7, 95%IC:2.1-10,6; p50.0001), pruritus (47.5%x7.6%, OR511,1, 95%IC:4.5-27; p<0.0001), vomiting (57.5%x31.1%, OR53.0, 95%IC:1.4-6.2, p50.04) and to have had at least 3 systems affected (47.5%x25%, OR52.7, 95%IC:1,3-5,6; p50,01). Age at 1 reaction was significantly lower on PG (average 3.8x9.5months; p50.03). Just 8% of all children were underweight. The median amount of CM to have a positive CMFC was 15mL, boys significantly reacted with less than 15mL (14x5, OR53.7, 95%IC:0.99-14.2; p50,06) and children who had referred to have diarrhea presented symptoms with more than 16mL (5x10, OR50.2, 95%IC:0,05-0,77; p0,02). During CMFC, half of FG patients presented with urticaria and 15%, anaphylaxis. CONCLUSIONS: Despite the high number of suspected children, just 1/3 really confirmed the diagnosis. Although there are some suggestive symptoms for CMA, they’re not specific enough to dismiss CMFC.