• Flavia Valença de Oliveira Neves, Cleonir de Moraes Lui Beck, Andrea Keiko Fujinami Gushken, Glauce Hiromi Yonamine, Ana Paula Beltran Moschione Castro, Mayra de Barros Dorna, Cristiane de Jesus Nunes Dos Santos, and Antonio Carlos Pastorino.
• MSc from Faculdade de Medicina, Universidade de São Paulo (FMUSP). Unit of Allergy and Immunology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
• Rev Assoc Med Bras (1992). 2016 Sep 1; 62 (6): 537-543.

Objective:To evaluate the wheal diameter in allergy skin-prick tests (SPT) with cow's milk extract (CM) comparing tolerant and persistent patients.Method:A retrospective cohort study involving database analysis of children with diagnosis of cow's milk protein allergy (CMPA) mediated by immunoglobulin E in a specialized outpatient clinic that regularly performed SPT between January 2000 and July 2015. Patients were allocated into two groups: tolerant or persistent. Comparisons were made at diagnosis and over time between tolerant and persistent patients using Fisher's, Mann-Whitney or Wilcoxon tests and significance level at 5%.Results:After applying inclusion and exclusion criteria, the sample includes 44 patients (29 tolerant and 15 who persisted with CMPA). In the tolerant group, the medians of SPT were: 6 mm at diagnosis and 2 mm at the development of tolerance; a significant difference (p<0.0001) was found. In the persistent group, the median SPT at diagnosis was 7 mm, while in the last SPT it was 5 mm, with no statistical difference (p=0.173). The comparison of medians in the last SPT between groups was significant (p=0.001), with a reduction greater than 50% in SPT in the tolerant group.Conclusion:Serial SPTs were useful for diagnosis, and a decrease higher than 50% in diameter can indicate the moment to perform oral food challenge (OFC) tests, helping to detect tolerance in CMPA.

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