Oral test

  • Sublingual provocative test
  • Subcutaneous provocative test
  • As already mentioned, the most widely used diagnostic method consists of three steps: the child is transferred to a milk-free diet, during which closely monitoring the course of disease and physiological indicators; then carried out the tests with reception of milk, registering a return of symptoms, and, finally, re exclude milk from the diet and watch the disappearance or weakening of symptoms.
    In Fig. 9 presents our proposed scheme of the oral trial with milk. In case of Allergy milk and dairy products completely exclude from food to 4 weeks. If the patient symptoms occur periodically, as it often happens, for example, diseases of the lungs, caused by the intake of milk, dates of milk-free diet should be a period equal to the longer the time interval between onset of symptoms plus 1 month. In older children to achieve complete elimination of milk from the diet harder than babies who are easy to replace cow's milk with soy mixture. If patients within 1-4 weeks't say no symptoms (in this period he is not receiving medical preparations), start spending oral samples of milk. This should be done under medical supervision, ambulatory or hospital, and in the event of adverse reactions, the personnel should be handy tools to help. These include epinephrine, antihistamines preparations for oral and intravenous aminophylline, sossoudossoujiwate drugs, IV solutions, oxygen and instruments for its submission, other devices and instruments necessary for the provision of urgent assistance. The observance of these precautions is especially important in those cases when the history data indicate pronounced reactions to milk or a patient responds to a small number (less than 2 ounces). If you are sensitive to milk the patient was on a strict milk-free diet more than 1 week, his reaction to milk, usually more severe than the original, ie, the symptoms that are emerging in response to the test, be more pronounced than previously [12]. Sometimes after the test can be a shock [13, 15]. It is characteristic that such reactions occur in cases where the parents or the patient himself aware of the possibility of their appearance in response to the intake of milk. Pronounced reaction to the sample almost not observed in patients with chronic rhinitis, lung disease, or hidden gastrointestinal bleeding caused by daily consumption of more than 1 liter of milk. Obviously detected in the history of the development of the patient severe reactions to milk should serve as a contraindication to the test; in this situation, it is done only for special reasons and with great care.
    The patient undergoes medical examination, and in case of detection of signs of Allergy, infection or disease, the test is delayed. During its holding for the patient should be favourable condition; neither the parents nor the staff shall not Express any concerns. In one study [13] the authors, noting the time symptoms appear after oral samples of milk, found that 39% of patients reaction occurred in the period less than 1 hour, 21 % - from 1 to 5 h 10% - from 6 to 11 hours, 17% - from 12 to 24 hours, 11 % - from 1 to 3 days and 1 % - after 7 days.
    For the sample used homogenized dairy milk containing 2% fat, or milk formula, which is presumably the reason for the development of symptoms in the patient. Dose milk sample is determined by the amount previously consumed milk and severity of the symptoms. A child with severe symptoms, it is recommended to start to give one drop of milk in a dilution of 1 : 100. Then gradually increase the dose at intervals of 1 h; one drop in a 1 : 10 dilution of one drop of undiluted milk, 10 drops of whole milk, 10 ml, and finally 100 ml, if the symptoms are still not appear. The maximum dose is reached after 6-7 hours and only in the absence of symptoms. Some children to determine test results may require repetition maximum dose for a few days.
    Pages: 1 2