Small intestinal mucosa IgE plasma cells and specific anti-cow milk IgE in children with cow milk protein intolerance
Schrander, J.J.; Dellevoet, J.J.; Arends, J.W.; Forget, P.P.; Kuijten, R.
Annals of Allergy 70(5): 406-409
1993
ISSN/ISBN: 0003-4738 PMID: 8498733 Document Number: 413672
In a prospective study, the presence was sought of both IgE plasma cells in small bowel mucosa and specific serum IgE antibodies to cow milk in children suspected of cow milk protein intolerance. 31 children with complaints possibly due to cow milk intolerance were submitted to 2 consecutive cow milk elimination/challenge tests. The diagnosis of cow milk protein intolerance was confirmed in 16 of 31 patients on the basis of 2 positive elimination/challenge tests. IgE plasma cells were found in 9 of 16 patients with proven cow milk protein intolerance and in only 1 of the 15 patients without cow milk protein intolerance (P<0.01). The radioallergosorbent test (RAST) for cow milk was positive in 6 of 16 infants with cow milk protein intolerance and in 2 of the 15 other infants. Serum IgE level was of no value in the diagnosis of cow milk protein intolerance. Neither of these diagnostic procedures was sensitive enough to be used as a screening test for cow milk protein intolerance. Furthermore, the relationship between specific IgE antibodies for cow milk and the presence of mucosal IgE plasma cells was poor: 5 of 9 infants with cow milk protein intolerance and with mucosal IgE plasma cells present had negative RASTs for cow milk.