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Component Resolved Diagnostics for Cow’s Milk Allergy in Children: a systematic review of diagnostic test accuracy
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  • Yong Wang,
  • Youfeng Ren,
  • Yuxiang Zhang,
  • Xuan Liang,
  • Rongfang Zhang
Yong Wang
Affiliated Hospital of Gansu University of Chinese Medicine
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Youfeng Ren
Affiliated Hospital of Gansu University of Chinese Medicine
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Yuxiang Zhang
Affiliated Hospital of Gansu University of Chinese Medicine
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Xuan Liang
Affiliated Hospital of Gansu University of Chinese Medicine
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Rongfang Zhang
Affiliated Hospital of Gansu University of Chinese Medicine

Corresponding Author:[email protected]

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Abstract

Background: The role of Component Resolved Diagnostics (CRD) in the diagnosis of cow’s milk allergy (CMA) remains highly controversial. In this systematic review, we aimed to evaluate the accuracy of CRD in diagnosing CMA in children. Methods: We searched four electronic databases (EMBASE, PubMed, the Cochrane Library, and Web of Science) from January 1, 2000, to March 27, 2023, for studies that utilized milk composition and oral food challenges (OFC) as a reference standard in patients with suspected milk allergy. The quality of the included studies was assessed using QUADAS-2. Due to the heterogeneity of the studies, a meta-analysis could not be performed, and a narrative synthesis of the findings was conducted. Results: Our analysis included 5 prospective studies, 2 retrospective studies, and 2 case-control studies, with a total of 958 children. The sensitivity of Bos d 4 ranged from 0.50 to 0.82, and specificity from 0.78 to 0.98. Bos d 5 sensitivity 0.24-1.0, and specificity 0.58-0.98. Bos d 6 sensitivity 0.09, and specificity 0.94. Bos d 8 sensitivity 0.34-0.90, specificity 0.79-0.98. CONCLUSION: The specific IgE (sIgE) of the Bos d 4, Bos d 6, and Bos d 8 components of milk is highly specific but not sensitive in diagnosing cow’s milk allergy in children. The use of CRD for the diagnosis of CMA in children may reduce the need for OFC.
22 Aug 2023Submitted to Pediatric Allergy and Immunology
23 Aug 2023Submission Checks Completed
23 Aug 2023Assigned to Editor
23 Aug 2023Review(s) Completed, Editorial Evaluation Pending
26 Aug 2023Reviewer(s) Assigned