Usefulness of Lymphocyte Stimulation Test for the Diagnosis of Intestinal Cow’s Milk Allergy in Infants

Vol. 157, No. 1, 2012

Article (Fulltext) Article (PDF 289 KB)

Original Paper

Usefulness of Lymphocyte Stimulation Test for the Diagnosis of Intestinal Cow’s Milk Allergy in Infants
Mitsuaki Kimura, Shigeharu Oh, Shigeyuki Narabayashi, Tomohide Taguchi

Department of Allergy and Clinical Immunology, Shizuoka Children’s Hospital, Shizuoka, Japan

Address of Corresponding Author

Int Arch Allergy Immunol 2012;157:58-64 (DOI: 10.1159/000323896)

Key Words

Cow’s milk allergy
Infants
Cell-mediated hypersensitivity
Lymphocyte stimulation test
ĸ-Casein

Abstract

Background: Bottle-fed infants sometimes develop intestinal cow’s milk allergy (ICMA). Because cow’s milk-specific IgE antibody (CM-IgE) levels are normal, the lymphocyte stimulation test (LST) has been proposed as an alternative diagnostic test for ICMA. The present study evaluated the diagnostic value of LST in a large number of patients with ICMA in Japan. Methods: Ninety-six infants who developed intestinal symptoms after ingestion of cow’s milk formula and showed remission of symptoms after elimination of this food were enrolled as patients with probable ICMA. Seventy-two subjects with normal CM-IgE levels and a positive result in an oral food challenge test (OFCT) for cow’s milk formula were diagnosed with ICMA. Another 10 infants with normal CM-IgE levels and a negative OFCT result were diagnosed with nonspecific intestinal symptoms (NIS). The status of cell-mediated immunity against cow’s milk proteins was estimated by LST for ĸ-casein. Results: In the 72 patients with ICMA (38 boys and 34 girls), the median age at onset was 9 days. Sixty-two of 72 (86.1%) patients with ICMA tested positive in the LST for ĸ-casein. In contrast, only 2 of the 10 NIS infants tested positive. The incidence of a positive LST result was significantly higher in the ICMA group than in the NIS group (p < 0.0001). The area under the receiver-operating characteristic curve for this test was as high as 0.856. Conclusions: This study strongly suggests that the LST for ĸ-casein is a useful diagnostic test for ICMA.

Author Contacts

Correspondence to: Dr. Mitsuaki Kimura
Department of Allergy and Clinical Immunology
Shizuoka Children’s Hospital
Urushiyama 860, Shizuoka City 420 8660 (Japan)
Tel. +81 54 247 6251, E-Mail kimurami@sch.pref.shizuoka.jp

Article Information

Received: August 30, 2010
Accepted after revision: December 22, 2010
Published online: September 6, 2011
Number of Print Pages : 7
Number of Figures : 4, Number of Tables : 4, Number of References : 17

Cited in Web of Science®

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