Currently diagnosis of allergies to milk concentrates more on clinical data than in the laboratory. The assumption about allergies to cow's milk occurs on the basis of the anamnesis, clinical symptoms of allergies, and in the absence of other disorders that may cause similar symptoms. Confirmation of the diagnosis is based on information about the improvement of the patient after the complete exclusion from the diet of milk, the return of symptoms in response to the test with the intake of milk and their subsequent disappearance by repeating milk-free diet. Without this three-step test, it is impossible to do if you are diagnosed with allergies to milk. Laboratory studies help in the diagnosis, if carried out by qualified personnel in specialized laboratories; however, they rarely are able to confirm or exclude a particular diagnosis and be most useful in combination with the specified three-step test. In these conditions, the definition of physiological, biochemical and histological abnormalities in response to an exception to the supply of milk and its subsequent admission is still the most reliable way to confirm the diagnosis of Allergy to cow's milk or other food products.
In the pathogenesis of allergies to milk included a variety of immunological mechanisms, and, unfortunately, there is no one method that allows you to confirm the diagnosis in any case. Laboratory methods may certainly help in the diagnosis if their choice was right in the clinical picture of the disease and the most likely immunological mechanisms underlying the various manifestations of Allergy (see Chapter IV). Always remember that in the pathogenesis of the disease, as a rule, included not one immunological reaction.
The necessity of correct diagnosis of Allergy to cow's milk is difficult to overestimate. Incorrectly diagnosed allergies leads to the fact that, having missed the true cause of the disease, doctors unnecessarily limit the consumption of milk or other products containing milk. Diagnosis of allergies to milk should be based on the following scheme.
To establish a preliminary diagnosis is required: the history data on the relationship between the intake of milk and symptoms of the disease; data about allergies (especially milk) for relatives; relevant clinical manifestations and the absence of any other causes development of similar symptoms.
Confirmation of the diagnosis is based on the observation except milk from the diet and its subsequent admission.
Additional methods that help diagnosis; skin tests: apikalova (scratch or subcutaneous), intradermal, application, test with "skin"window, passive transfer of hypersensitivity; determination of eosinophils in the blood and the local secret; determination of serum immunoglobulins, including the total IgE level; definition of specific antibodies against proteins of milk: radioallergosorbent test (RAST), enzyme-ELISA method (FIM), the reaction of precipitation and haemagglutination reaction of binding complement, immune complexes; research methods of leukocytes in vitro; the release of leukocyte histamine, cytotoxic food test lymphoblastic transformation, products lymphokines; bowel biopsy.