Premium
Fractional exhaled nitric oxide in infants during cow’s milk food challenge
Author(s) -
Gabriele Carmelo,
Hol Jeroen,
Kerkhof Evelien,
Elink Schuurman Beatrix E. E.,
Samsom Janneke N.,
Hop Wim,
Nieuwenhuis Edward E. S.,
De Jongste Johan C.
Publication year - 2008
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/j.1399-3038.2007.00673.x
Subject(s) - medicine , exhaled nitric oxide , cow milk , nitric oxide , food science , asthma , spirometry , chemistry
Cow’s milk allergy (CMA) is the most common food allergy in early childhood. The golden standard for the diagnosis of CMA is a food challenge after a period of elimination. Increased levels of fractional exhaled nitric oxide (FE NO ) have been shown after bronchial allergen provocation. We evaluated whether FE NO may also be a predictor of a positive reaction during cow’s milk challenge in infants. Forty‐four infants [mean age (range): 4.2 (3.7–4.6) months] suspected of CMA underwent an open food challenge with cow’s milk formula administered in ascending quantities, starting with 2 ml and then 6, 20, 60 and 200 ml until a clinical reaction occurred. Off‐line FE NO samples were obtained during tidal breathing by means of a facemask covering infants’ nose and mouth. FE NO was measured twice before the challenge (baseline), immediately before each new dose of milk and after a positive reaction or after the last dose of milk. Eleven children showed immediate positive clinical responses to cow’s milk, whereas 13 infants presented only a late‐type reaction. FE NO values before or after a positive reaction (either immediate or late) were not different from FE NO values at baseline. Baseline FE NO in infants with a positive reaction did not differ from FE NO in infants without a reaction at any time point. We conclude that FE NO values are not predictive and not related to the occurrence of a positive reaction during a cow’s milk challenge in infants, suggesting that a positive reaction may not result from eosinophilic activation.