Teste de provocação oral aberto na confrmação de alergia ao leite de vaca mediada por igE: Qual seu valor na prática clínica?

Abstract

Objective: To review the main standardization protocols of the open oral food challenge applied to children with suspicion of cow's milk allergy mediated by immunoglo-bulin E.Data source: Medline, Lilacs and SciELO databases were searched for articles published in the last ten years using the following descriptors: "food hypersensitivity", "cow's milk", "cow's milk allergy", "oral food challenge", "children" and "diagnosis". Data synthesis: The oral food challenge test is the most reliable method to establish or exclude the diagnosis of food allergy and the open challenge can be the first option when only objective reactions are expected. All medications and equipment needed for emergency treatment should be available. Before being submitted to the test, the patient must follow a diet excluding the suspected food and discontinue the use of medications that may interfere with the results of the test. Usually, it is performed using 8-10g of powdered milk or 100mL of fluid milk, offered in progressive volumesat intervals of ten toT 60 minutes. Despite the rigour of the method, there are still situations difficult to interpret. Therefore, well-trained doctors must administer the test, being cautious about their clinical judgment. Conclusions: Although there are some restrictions in the application of the oral food challenge test with cow's milk in the clinical practice, its implementation in health services could reduce false positive diagnoses of allergies.