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Titolo:
Peanaut challenge: a retrospective study of 140 patients
Autore:
Pucar, F; Kagan, R; Lim, H; Clarke, AE;
Indirizzi:
Montreal Gen Hosp, Div Clin Epidemiol, Montreal, PQ H3G 1A4, Canada Montreal Gen Hosp Montreal PQ Canada H3G 1A4 Montreal, PQ H3G 1A4, Canada Montreal Gen Hosp, Div Allergy Clin Immunol, Montreal, PQ H3G 1A4, Canada Montreal Gen Hosp Montreal PQ Canada H3G 1A4 Montreal, PQ H3G 1A4, Canada McGill Univ, Montreal Childrens Hosp, Div Allergy Clin Immunol, Montreal, PQ H3H 1P3, Canada McGill Univ Montreal PQ Canada H3H 1P3 unol, Montreal, PQ H3H 1P3, Canada
Titolo Testata:
CLINICAL AND EXPERIMENTAL ALLERGY
fascicolo: 1, volume: 31, anno: 2001,
pagine: 40 - 46
SICI:
0954-7894(200101)31:1<40:PCARSO>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONTROLLED FOOD CHALLENGES; PEANUT ALLERGY; DOUBLE-BLIND; ATOPIC-DERMATITIS; NUT ALLERGY; HYPERSENSITIVITY; CHILDREN; PREVALENCE;
Keywords:
peanut allergy; children; food challenge; sensitivity; specificity; predictive value; prick skin test;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Clarke, AE Montreal Gen Hosp, Div Clin Epidemiol, 1650 Cedar Ave, Montreal, PQ H3G 1A4, Canada Montreal Gen Hosp 1650 Cedar Ave Montreal PQ Canada H3G 1A4 ada
Citazione:
F. Pucar et al., "Peanaut challenge: a retrospective study of 140 patients", CLIN EXP AL, 31(1), 2001, pp. 40-46

Abstract

Background Accurate diagnosis of peanut allergy is essential given that itis a lifelong and potentially fatal food allergy. Diagnosis relies on patient history, prick skin test (PST), and in many situations, food challenge. More information is required on the safety of food challenge and the informational value of a PST. Objectives Primary: to assess the safety of peanut challenges. Secondary: to estimate the sensitivity, specificity, and the positive and negative predictive values of PST to peanut performed in those who underwent a peanut challenge. Methods A retrospective study of peanut challenges performed at a tertiarycare paediatric hospital allergy clinic between January 1994 and November 1998. Results Of the 140 peanut challenges performed on 140 patients, Is were positive. The most frequent adverse clinical effects of positive peanut challenges were: urticaria, oropharyngeal irritation, rhinitis, vomiting and abdominal pain. Among the Is patients who had a positive result, 10 required medical treatment (antihistamines, +/- epinephrine, +/- salbutamol) to control the allergic reaction. The sensitivity, specificity, and the positive and negative predictive values of PST to peanut in this group of children undergoing a peanut challenge were 100%, 62.3%, 28.1% and 100%, respectively. Conclusions Given the poor positive predictive value and specificity of PST, a peanut challenge is usually required to diagnose peanut allergy with certainty when the PST is positive. In cases of a clear history of anaphylaxis to peanut and a positive PST, challenges are unwarranted. When the history is strongly suggestive and the PST is borderline positive, i.e. 3 or 4 mm, peanut challenge is generally necessary to confirm the diagnosis. Given the excellent negative predictive value and sensitivity of PST, a blinded peanut challenge is usually unnecessary in the context of a negative PST except for patients with a history strongly suggestive of immediate hypersensitivity. These patients should be individually assessed for the need to undergo a blinded challenge. The peanut challenge is a useful and safe diagnostic tool when performed by qualified personnel under appropriate conditions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/21 alle ore 02:32:56