Utility of food-specific IgE concentrations in predicting symptomatic food allergy

Author(s): Sampson HA

Abstract

Background:The double-blind, placebo-controlled food challenge is considered the gold standard for diagnosing food allergy. However, in a retrospective analysis of children and adolescents with atopic dermatitis and food allergy, discrete food-specific IgE concentrations were established that could predict clinical reactivity to egg, milk, peanut, and fish with greater than 95% certainty.

Objective:The purpose of this investigation was to determine the utility of these 95% predictive decision points in a prospective evaluation of food allergy.

Methods:Sera from 100 consecutive children and adolescents referred for evaluation of food allergy were analyzed for specific IgE antibodies to egg, milk, peanut, soy, wheat, and fish by using the Pharmacia CAP System FEIA. Food-specific IgE values were compared with history and the results of skin prick tests and food challenges to determine the efficacy of previously established 95% predictive decision points in identifying patients with increased probability of reacting during a specific food challenge.

Results:One hundred children (62% male; median age, 3.8 years; range, 0.4-14.3 years) were evaluated for food allergy. The diagnosis of food allergy was established by means of history or oral food challenge. On the basis of the previously established 95% predictive decision points for egg, milk, peanut, and fish allergy, greater than 95% of food allergies diagnosed in this prospective study were correctly identified by quantifying serum food-specific IgE concentrations.

Conclusion:In a prospective study of children and adolescents referred for evaluation of food allergy, previously established 95% predictive decision points of food-specific IgE antibody concentrations for 4 major food allergens were effective in predicting clinical reactivity. Quantification of food-specific IgE is a useful test for diagnosing symptomatic allergy to egg, milk, peanut, and fish in the pediatric population and could eliminate the need to perform double-blind, placebo-controlled food challenges in a significant number of children.

Similar Articles

Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma

Author(s): Guilbert TW, Morgan WJ, Zeiger RS, Bacharier LB, Boehmer SJ, et al.

A revised nomenclature for allergy

Author(s): Johansson SG, Hourihane JO, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, et al.

[Time trends and geographical variations in the prevalence of symptoms of allergic rhinitis in 6-7-year-old children from eight areas of Spain according to the ISAAC]

Author(s): Arnedo-Pena A, García-Marcos L, García Hernández G, AguinaguaOntoso I, González Díaz C, et al.

Comparison of skin tests to aeroallergens in Ankara and Seoul

Author(s): Sener O, Kim YK, Ceylan S, Ozanguc N, YooTJ,et al.

Recent invasion of the mountain birch Betulapubescens ssp

Author(s): Truong C, Palmé AE, Felber F

Production of allergenic pollen by ragweed (Ambrosia artemisiifolia L

Author(s): Wayne P, Foster S, Connolly J, Bazzaz F, Epstein P

Heat requirement for the onset of the Oleaeuropaea L

Author(s): Galán C, García-Mozo H, Vázquez L, Ruiz L, de la Guardia CD, et al.

Cities as harbingers of climate change: common ragweed, urbanization, and public health

Author(s): Ziska LH, Gebhard DE, Frenz DA, Faulkner S, Singer BD, et al.

Bronchial hyper-responsiveness and atopy in urban, peri-urban and rural South African children

Author(s): Steinman HA, Donson H, Kawalski M, Toerien A, Potter PC

Continued increase in the prevalence of asthma and atopy

Author(s): Downs SH, Marks GB, Sporik R, Belosouva EG, Car NG, et al.

Allergy practice worldwide: a report by the World Allergy Organization Specialty and Training Council

Author(s): Warner JO, Kaliner MA, Crisci CD, Del Giacco S, Frew AJ, et al.

Continued increase in the prevalence of asthma and atopy

Author(s): Downs SH, Marks GB, Sporik R, Belosouva EG, Car NG, et al.

The work impact of asthma and rhinitis: findings from a population-based survey

Author(s): Blanc PD, Trupin L, Eisner M, Earnest G, Katz PP, et al.

The natural history of peanut allergy

Author(s): Skolnick HS, Conover-Walker MK, Koerner CB, Sampson HA, Burks W, et al.

Aeroallergen sensitivity of Thai patients with allergic rhinitis

Author(s): Pumhirun P, Towiwat P, Mahakit P

House dust mite allergen in US beds: results from the First National Survey of Lead and Allergens in Housing

Author(s): Arbes SJ Jr, Cohn RD, Yin M, Muilenberg ML, Burge HA, et al.

Prevalence of indoor allergen exposures among New Orleans children with asthma

Author(s): Rabito FA, Iqbal S, Holt E, Grimsley LF, Islam TM, et al.

House dust mite and cat allergen in different indoor environments

Author(s): Custovic A, Taggart SC, Woodcock A

Longitudinal variability of skin prick test results

Author(s): Kuehr J, Karmaus W, Frischer T, Hendel-Kramer A, Weiss K, et al.