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즉시형 우유 알레르기 환자에서 카제인 특이 IgE와 IgG의 유용성
임자현 ( Ja Hyun Lim ),정경욱 ( Kyung Uk Jeong ),이정민 ( Jeong Min Lee ),이경은 ( Kyung Eun Lee ),이수영 ( Soo Young Lee ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2
Purpose: Cow`s milk-specific IgE (CM-IgE) has been proposed as one of the valuable markers for diagnosis of clinical cow`s milk (CM) allergy. In this study, we evaluated the additional usefulness of casein-specific IgE (casein-IgE) and IgG (casein-IgG) for the diagnosis of clinical CM allergy. Methods: Fifty-eight subjects, aged from 3 months to 154 months, were enrolled. Thirty-four patients showed immediate-type of clinical CM allergy, and 24 patients were atopic controls. The serum levels of CM-IgE, casein-IgE, and casein-IgG were measured. Pa￢tients were divided into 2 groups: those aged under 12 months and those aged 12 months or over. The diagnostic values of each antibody were analyzed and compared using the Mann-Whitney U-test and receiver operating characteristic curves. Results: CM allergy had significantly higher levels of CM-IgE and casein-IgE, and lower levels of casein-IgG/IgE ratio when compared to atopic controls in both age groups (P<0.05). CM-IgE and casein-IgE were shown to be better predictive markers for immediate-type CM allergy in patients under 12 months, while casein-IgG/IgE ratio was a more useful marker in those aged 12 months or over. Considering 100% positive predictive values, cutoff points were 1.04 kU/L for CM-IgE, 0.11 kU/L for casein-IgE, 19.5 for casein-IgG/IgE ratio in patients aged under 12 months, and 7.1 kU/L for CM-IgE, 1.41 kU/L for casein-IgE, 12.51 for casein-IgG/IgE ratio in those aged 12 months or over. Conclusion: CM-IgE, casein-IgE, and casein-IgG/IgE ratio are useful markers for predicting immediate-type CM allergy. Further stud￢ies are needed on diagnostic decision points for CM allergy using combination of cutoff values of these 3 markers.(Allergy Asthma Respir Dis 2015;3:139-144)
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