[Challenge for cow's milk protein intolerance diagnosis. Comparison between different modalities].

BACKGROUND: The diagnosis of cow's milk protein intolerance (CMPI) is mainly based on the response to the elimination diet and to the subsequent exposure to these proteins (challenge). METHODS: To find out whether a "formal", strictly scheduled challenge was better than a less formal test in establishing CMPI diagnosis, records were reviewed of 87 children studied in 5 Hospitals in the Milan area during the last 3 years. RESULTS: The study showed that the diagnostic approach (formal vs informal challenge) did not affect the probability of confirming CMPI diagnosis (21% vs 19%). Moreover, this probability was not affected by the source of the first diagnosis (Hospital vs Family Doctor), the time elapsed between first diagnosis and challenge, and the laboratory tests performed during the challenge. CONCLUSIONS: Therefore, a less strictly scheduled approach could be conveniently suggested to confirm CMPI diagnosis, at least in unselected cases.