الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cow’s milk allergy(CMA) is the most common cause of food allergy in infancy and childhood. It affects 2% to 3% of infants who are typically sensitized to distinct cow’s milk (CM) proteins. Allergy to cow’s milk protein (CMP) is an immunologically mediated reaction to one or more of the milk proteins. These proteins include caseins and whey proteins. Cow milk allergy can be further split into IgE and non-IgE (mostly cellular) mediated. While IgE-mediated reactions are well recognized with validated diagnostic tests, the non IgE-mediated immune reactions that can arise in the gastro-intestinal tract are not so well defined and more difficult to recognize. Ig E-mediated allergy is associated with atopic manifestations such as urticaria, angioedema, vomiting, diarrhea, eczema, rhinitis, and anaphylaxis. Non-IgE-mediated allergy is associated with symptoms including gastro-esophageal reflux, vomiting, constipation, hemosiderosis, malabsorption, villous atrophy, eosinophilic proctocolitis, enterocolitis, and eosinophilic esophagitis. Specific IgE testing helps to confirm diagnosis in IgE-mediated allergy, and prick tests can be used to add value to the diagnosis, but positive results are not necessarily predictive for food challenge outcome. This study was carried on to evaluate the role of lactoglobulin specific IgE and lactalbumin specific IgE in children suspected to have milk protein allergy. This study was done at Medical Biochemistry and pediatrics departments, Faculty of Medicine, Menofiya University. This study was carried on 70 subjects, 50 patients suspected to have milk protein allergy and 20 apparently health persons. Full history taking and clinical examination, laboratory tests were done including complete blood picture, serum total IgE, serum lactalbumin specific IgE, serum lactoglobulin specific IgE and serum total proteins and albumin level. The results of the current study can be summarized as follows:- Significant statistical difference as regard immediate symptoms, skin lesions, family history and respiratory symptoms between studied groups and non significant breast feeding. Significant increase in eosinophils %, lactoglobulin IgE and lactalbumin IgE ,increase in WBCs count and total IgE level in patients group while a significant decrease in total proteins. The diagnostic accuracy of total IgE in diagnosis of protein allergy is (59%), with sensitivity of (44%), specificity (95%), positive predictive value (96%) and negative predictive value (40%) at cutoff point of 50.05 IU/L. The diagnostic accuracy of lactoglobulin specific IgE in diagnosis of protein allergy is (84%), with sensitivity of (78%), specificity (100%), positive predictive value (100%) and negative predictive value (65%) at cutoff point of 0.345 IU/ml. The diagnostic accuracy of lactalbumin specific IgE in diagnosis of protein allergy is (83%), with sensitivity of (84%), specificity (80%), positive predictive value (91%) and negative predictive value (67%) at cutoff point of 0.335 IU/ml. There is significant statistical difference between positive and negative cases of total Ig E in infant suggestive of cow milk protein allergy according to family history, breast feeding and immediate symptom and non significant statistical difference according to respiratory symptoms and skin lesions. There is significant statistical difference between positive and negative cases of lactoglobulin Ig E in infant suggestive of cow milk protein allergy according to family history and nonsignificant statistical difference according to breast feeding, immediate symptoms, respiratory symptoms and skin lesions. there is significant statistical difference between positive and negative cases of total IgE in infant suggestive of cow milk protein allergy according to WBCs count, eosinophil%, lactoglobulin Ig E and lactalbumin IgE. There is significant statistical diffrence difference between positive and negative cases of lactoglobulin Ig E in infant suggestive of cow milk protein allergy according to eosinophil% and total Ig E, RBCs count and lactalbumin Ig E. There is significant statistical difference between positive and negative cases of lactalbumin Ig E in infant suggestive of cow milk protein allergy according to eosinophil%, total Ig E and lactoglobulin Ig E. The combination of lactalbumin specific IgE and lactoglobulin specific IgE showed the best diagnostic accuracy between IgE combinations.