Diagnosing peanut allergy with skin prick and specific IgE testing
Diagnosing peanut allergy with skin prick and specific IgE testing
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DOI：
10.1016/j.jaci.2005.02.038
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发表时间：
2005-06-01
影响因子：
14.2
通讯作者：
Lack, G
中科院分区：
文献类型：
--
作者：
Roberts, G;Lack, G
背景：食物过敏在儿童时期很常见。已有研究表明，皮肤点刺试验或特异性IgE结果的大小可以提高诊断的有效性，但这一点仅在少数基于第三次挑战的研究中得到解决。目的：确定风疹和特异性IgE>；=8 mm或血清特异性IgE和gt；=15ku(A)/L对临床过敏的预测价值，并调查结果是否具有普遍性。方法：所有16岁以下的受试者，曾接受花生或树坚果食物挑战的研究均符合研究条件。受试者来自三级过敏诊所或社区出生队列。所有有食物过敏病史的受试者都被提出了挑战，除非有过敏反应的特征。挑战的细节被前瞻性地记录下来。结果：共有161个花生挑战。最近的皮肤点刺(最长风团直径)和特异性IgE数据分别适用于135和136个挑战。结果表明，皮肤点刺结果<gt；=8 mm和特异性IgE>；=15ku(A)/L对积极挑战的预测值分别为95%(95%CI，76.2%~99.9%)和92.0%(74.0%~99.0%)。年龄、坚果类型和受试者的转诊模式似乎没有改变这种关系。结论：这些数据表明，皮肤刺痛结果=8 mm或特异性Ig E>；=15Ku(A)/L对临床花生过敏有很高的预测价值，这些临界值似乎适用于接受花生过敏评估的不同儿童群体。
Background: Food allergy is common in childhood. It has been suggested that the magnitude of a skin prick test or specific IgE result can improve diagnostic usefulness, but this has been addressed in only a few tertiary challenge-based studies.Objective: To determine the predictive value of a wheal >= 8 mm or serum specific IgE >= 15 kU(A)/L for clinical allergy and investigate whether results are generalizable.Methods: All subjects, up to 16 years of age, who had been investigated with a peanut or tree nut food challenge were eligible for the study. Subjects were referred from either a tertiary allergy clinic or a community birth cohort. All subjects with a history suggestive of food allergy were offered a challenge unless there were features of anaphylaxis. Details of challenges were prospectively recorded. Results were modeled by using logistic regression.Results: There was a total of 161 peanut challenges. Recent skin prick (longest wheal diameter) and specific IgE data were available for 135 and 136 challenges, respectively. The results suggest that a skin prick result >= 8 mm and a specific IgE >= 15 kU(A)/L have predictive values of 95% (95% CI, 76.2% to 99.9%) and 92.0% (74.0% to 99.0%), respectively, for a positive challenge. Age, the type of nut, and referral pattern of the subject did not appear to alter this relationship.Conclusion: These data suggest that a skin prick result >= 8 mm or a specific IgE >= 15 kU(A)/L have a high predictive value for clinical allergy to peanut and that these cutoff figures appear generalizable to different populations of children undergoing an assessment for peanut allergy.