Table 3.
Studies reporting on sIgE as a predictor of the prognosis of MILK allergy.
| Author | N | Study design | Diagnosis | Age 1 | Period of follow-up | Follow-up diagnosis | Tolerance | SPT (mm) | sIgE (kUA/L) |
|---|---|---|---|---|---|---|---|---|---|
| Yavuz 2013 [53] | 148 | Retrospective | Clinical history, positive SPT/sIgE and either positive OFC or history of anaphylaxis | 1.6 years (IQR 0.9–3.1 years) | 3.5 years (IQR 1.8–5.2 years) | OFC if sIgE low and no recent reaction | 45% | Age-specific 95% PPVs to persistent allergy | |
| <1 years: 1.4 | |||||||||
| <2 years: 9.3 | |||||||||
| <4 years: 9.4 | |||||||||
| <6 years:11 | |||||||||
| All: 11 | |||||||||
| Suh 2011 [36] | 115 | Retrospective | Clinical history and sIgE > 0.35; or sIgE > 5 | <24 months | Mean 47 months (range 24–114 months) | OFC or home introduction | 41% | Higher peak sIgE in first 24 months reduced probability of tolerance. | |
| Savilahti 2010 [46] | 83 | Prospective birth cohort (n = 6,209) | Open OFC and SPT ≥ 3 mm or sIgE ≥ 0.7 | 7 months | Up to 8 years | OFC or home introduction | 78% | sIgE higher in those with persistent allergy | |
| Santos 2010 [54] | 66 | Retrospective | OFC and SPT or sIgE | NR | Median 7 years | OFC if SPT or sIgE decreased and no recent reaction | 50% | Peak > 10 mm reduced the likelihood of tolerance (HR 0.38, 95% CI 0.14–0.99) | Higher maximum sIgE over time reduced the likelihood of tolerance |
| Martorell 2008 [16] | 170 | Prospective | Clinical history or OFC, and SPT or sIgE | 5.4 months (1–12 months) | Up to 4 years of age | OFC if no reaction in previous 3 months | 82% | Age-specific 95% PPVs to persistent allergy | |
| 12 months: 5.86 | |||||||||
| 18 months: 9.79 | |||||||||
| 24 months: 25.7 | |||||||||
| 36 months: 7.38 | |||||||||
| 48 months: 5.0 | |||||||||
| Skripak 2007 [23] | 807 | Retrospective review | Clinical history plus OFC or elimination diet | 13 months (range 1–209 months) | Median 54 months | OFC if sIgE < 2; or home introduction | 15% | Higher peak sIgE reduced probability of tolerance. | |
| Saarinen 2005 [17] | 86 | Prospective birth cohort | Elimination challenge test | 7 months | Up to 8 years | Home challenge test or OFC | 85% | SPT 12 months after diagnosis: ≥7 mm AUC 0.84 | |
| Perry 2004 [14] | 166 | Retrospective chart review | Clinical history or SPT/sIgE | NR | NR | OFC if clinically indicated | 45% | <2 50% probability of tolerance | |
| Garcia-Ara 2004 [44] | 66 | Prospective | OFC | 4.8 months (range 1–11 months) | Mean 32.9 months (range 9–99 months) | OFC | 68% | Age-specific 95% PPVsto persistent allergy | |
| 13–18months: 2.7 | |||||||||
| 19–24months: 9 | |||||||||
| 26–36months: 24 | |||||||||
| Shek 2004 [33] | 49 | Retrospective | DBPCFC | 34 months | Up to 10 years | DBPCFC | 33% | sIgE decrease of 50% in 12 months—0.31 probability of tolerance | |
| sIgE decrease of 90% in 12months—0.66 probability of tolerance | |||||||||
| Hill 1993 [45] | 69 | Prospective | OFC or SPT | 20 months | Median 24 months | Home introduction or OFC at 5 years of age | 22% | Lower in transient allergy | |
| James 1992 [42] | 29 | DBPCFC | 7 years (range 3–14 years) | Median 3 years | DBPCFC | 38% | Not predictive of tolerance | Not predictive of tolerance | |
| Sampson 1989 [12] | 21 | Retrospective | DBPCFC | 7.9 years (range 3–18 years) | 1–3 years | DBPCFC or accidental ingestion | 19% | Not predictive of tolerance |
NR: not reported; HR: hazards ratio; 1 Age at diagnosis or entry into study; reported as mean or median (range).