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Assessment of Cow's milk-related symptom scores in early identification of cow's milk protein allergy in Chinese infants.
BMC Pediatr. 2019 06 10; 19(1):191.BPed

Abstract

BACKGROUND

The diagnosis of cow's milk protein allergy(CMPA) may be easily misdiagnosed due to its lack of specific symptoms. Thus, experts have proposed the use of Cow's milk-related symptom scores (CoMiSS) to predict CMPA. There has been no relevant report on the clinical application value of CoMiSS in Chinese children. This study aimed to evaluate the effect of CoMiSS in early identification of CMPA in Chinese infants.

METHODS

We calculated CoMiSS for 38 infants with suspected CMPA diagnosed in the pediatric gastroenterologic clinic in our hospital. After 4 weeks of dietary elimination and symptomatic improvement, these infants returned to our hospital to undergo oral food challenge (OFC). The ROC curve was used to determine the sensitivity and specificity of CoMiSS and evaluate the effect of CoMiSS in early identification of CMPA in Chinese infants. We didn't determine the CoMiSS of presumed healthy infants as control group.

RESULTS

Of 38 infants who underwent OFC testing, the average CoMiSS of infants with positive OFC testing was 7.4 ± 2.3, while the average CoMiSS of infants with negative OFC testing was 4.1 ± 1.6, and there was a significant difference between two groups(F = 2.13, P<0.05). The area under the ROC curve (AUC) of CoMiSS was 0.89, and the best diagnostic cut-off point was 5.5. The sensitivity of CoMiSS was 87.5%, while the specificity of CoMiSS was 78.6%.

CONCLUSION

CoMiSS is a simple and operable method to screen for CMPA, though there may be a risk of under-diagnosis when CoMiSS≥12 is used as the criterion for early identification of CMPA in Chinese infants. More multi-center studies are needed to evaluate whether the factors such as bloody stool should be included in CoMiSS or CoMiSS≥6 can be used as the criterion for early identification of CMPA in Chinese infants.

Authors+Show Affiliations

The First Affiliated Hospital, Jinan University, Guangzhou, 510630, Guangdong, China. zymdoctor2006@126.com. Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China. zymdoctor2006@126.com.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.Department of Pediatrics, Shenzhen Maternity and Child Healthcare Hospital, 2004# Hongli Road, Futian District, Shenzhen, 518000, Guangdong, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31179927

Citation

Zeng, Yongmei, et al. "Assessment of Cow's Milk-related Symptom Scores in Early Identification of Cow's Milk Protein Allergy in Chinese Infants." BMC Pediatrics, vol. 19, no. 1, 2019, p. 191.
Zeng Y, Zhang J, Dong G, et al. Assessment of Cow's milk-related symptom scores in early identification of cow's milk protein allergy in Chinese infants. BMC Pediatr. 2019;19(1):191.
Zeng, Y., Zhang, J., Dong, G., Liu, P., Xiao, F., Li, W., Wang, L., & Wu, Q. (2019). Assessment of Cow's milk-related symptom scores in early identification of cow's milk protein allergy in Chinese infants. BMC Pediatrics, 19(1), 191. https://doi.org/10.1186/s12887-019-1563-y
Zeng Y, et al. Assessment of Cow's Milk-related Symptom Scores in Early Identification of Cow's Milk Protein Allergy in Chinese Infants. BMC Pediatr. 2019 06 10;19(1):191. PubMed PMID: 31179927.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of Cow's milk-related symptom scores in early identification of cow's milk protein allergy in Chinese infants. AU - Zeng,Yongmei, AU - Zhang,Jiyong, AU - Dong,Guoqing, AU - Liu,Peihui, AU - Xiao,Fei, AU - Li,Weiyan, AU - Wang,Liting, AU - Wu,Qianzhen, Y1 - 2019/06/10/ PY - 2018/09/26/received PY - 2019/05/30/accepted PY - 2019/6/11/entrez PY - 2019/6/11/pubmed PY - 2020/7/4/medline KW - CoMiSS allergy food allergy food hypersensitivity Oral food challenge infant SP - 191 EP - 191 JF - BMC pediatrics JO - BMC Pediatr VL - 19 IS - 1 N2 - BACKGROUND: The diagnosis of cow's milk protein allergy(CMPA) may be easily misdiagnosed due to its lack of specific symptoms. Thus, experts have proposed the use of Cow's milk-related symptom scores (CoMiSS) to predict CMPA. There has been no relevant report on the clinical application value of CoMiSS in Chinese children. This study aimed to evaluate the effect of CoMiSS in early identification of CMPA in Chinese infants. METHODS: We calculated CoMiSS for 38 infants with suspected CMPA diagnosed in the pediatric gastroenterologic clinic in our hospital. After 4 weeks of dietary elimination and symptomatic improvement, these infants returned to our hospital to undergo oral food challenge (OFC). The ROC curve was used to determine the sensitivity and specificity of CoMiSS and evaluate the effect of CoMiSS in early identification of CMPA in Chinese infants. We didn't determine the CoMiSS of presumed healthy infants as control group. RESULTS: Of 38 infants who underwent OFC testing, the average CoMiSS of infants with positive OFC testing was 7.4 ± 2.3, while the average CoMiSS of infants with negative OFC testing was 4.1 ± 1.6, and there was a significant difference between two groups(F = 2.13, P<0.05). The area under the ROC curve (AUC) of CoMiSS was 0.89, and the best diagnostic cut-off point was 5.5. The sensitivity of CoMiSS was 87.5%, while the specificity of CoMiSS was 78.6%. CONCLUSION: CoMiSS is a simple and operable method to screen for CMPA, though there may be a risk of under-diagnosis when CoMiSS≥12 is used as the criterion for early identification of CMPA in Chinese infants. More multi-center studies are needed to evaluate whether the factors such as bloody stool should be included in CoMiSS or CoMiSS≥6 can be used as the criterion for early identification of CMPA in Chinese infants. SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/31179927/Assessment_of_Cow's_milk_related_symptom_scores_in_early_identification_of_cow's_milk_protein_allergy_in_Chinese_infants_ L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1563-y DB - PRIME DP - Unbound Medicine ER -