Derya Ufuk ALTINTAŞ, Gülşah Duyuler AYÇİN

Contribution of the method of diagnosis and the range of IgE -non IgE at cow's milk allergy in daily practice

Amaç: İnek sütü alerjisi olan hastalarımızın immün reaksiyonun tipine göre dağılımını ve tanı yöntemlerinin rutin uygulamadaki yerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Nisan 2014- Aralık 2014 arası ÇÜTF Çocuk Alerji- İmmünoloji kliniğine başvuran hastalardan inek sütü alerjisi düşünülen 54 hasta alındı. Laboratuar değerlendirmede eozinofil sayısı, süt spesifik immungloblin E, deri prik test, prik to prik testi, yama testi ve süt yükleme testi yapıldı. Bulgular: Hastaların (n:54) %50'si (n:27) kız ve %50'si (n:27) erkekti. Tüm hastaların yaş ortalaması 38,3±37,9 aydı. Hastaların %66,6'sı (n:36) IgE aracılı, %14'ü (n:8) miks tip, %18,5 (n:10) Non IgE aracılı idi. IgE aracılıklı 36 hastanın %88,8'ine inek sütü yükleme testi yapıldı. %34,3'ünde (n:11) yükleme testi pozitifti. Miks gruptaki 8 hastanın 5'ine inek sütü yükleme testi yapıldı %40'ında pozitif bulundu. Non IgE grubunda 10 hastadan 7'sine inek sütü yükleme testi yapıldı ve hiçbirinde pozitif bulunmadı. Sonuç: Bu çalışmada IgE aracılıklı olgulara (%66,6), Non IgE ve miks gruba göre daha sık rastladık. Eozinofil düzeylerinde gruplar arasında fark bulunmadı. Beklendiği gibi süt spesifik IgE, IgE aracılıklı grupta yüksek iken deri prik test pozitifliği miks grupta yüksekti. Yama testi IgE aracılıklı grupta %30, miks grupta %12 pozitif iken Non IgE grubunda hiçbir hastada pozitif bulunmadı. Bu çalışmada iki dikkat çekici sonuç vardır; yama testi Non IgE grupta pozitif beklenirken IgE ve miks grupta pozitif bulundu ve IgE aracılıklı grupta yama testi pozitif olanlarda yükleme testleri pozitifti

Günlük pratikte inek sütü alerjisinde IgE non IgE dağılımı ve tanı yöntemlerinin katkısı

Aim: It is aimed to evaluate the place of the diagnosis method in routine practice and the ISA patients range according to the types of immune reactions. Materials and Methods: 54 patients were taken among patients considered cows milk allergy and also consulted at ÇUTF children allergy immunology clinic between April 2014 and December 2014. As a laboratory evaluation the amount of eosinophils, milk spesific IgE, skin prick test, prick to prick test, patch test and provocation performed. Results: 50% (n:27) of patients were male and 50% (n:27) were female. All patients ages average was 38,3 ±37,9 month. 66,6% (n:36) of patients were IgE referenced, 14% (n:8) mix type, 18,5% (n:10) Non IgE referenced. Provocation is done 88,8% of patients amoung 36 IgE referenced patients. The test was positive at 34,3% (n:11). The provocation test was done 5 patients among 8 patients mix group, the 40% of patients results were positive. At Non IgE referenced group, test is done on 7 patients among 10 and no positive results were found. Conclusion: In this study, we encountered more IgE referenced diagnosis (66,6%) when compared to Non IgE and mix group. Eosinophils showed no difference between groups. It can be guessed that while milk specific IgE was high in IgE referenced group, it was high in SPT mix group, too. Patch test at IgE referenced group was 30%, at mix group was 12%, on the other hand there was no positive result at Non IgE group patients. In this study, there are two striking results: Patch test are found positive at IgE and mix group when it is guessed it may be possitive at Non IgE group and at IgE referenced group, the patients whose patch test 'are positive had also positive provocation tests

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