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Titolo:
Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis
Autore:
Roehr, CC; Reibel, S; Ziegert, M; Sommerfeld, C; Wahn, U; Niggemann, B;
Indirizzi:
Humboldt Univ, Univ Childrens Hosp Charite, Dept Pneumol & Immunol, Berlin, Germany Humboldt Univ Berlin Germany e, Dept Pneumol & Immunol, Berlin, Germany
Titolo Testata:
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
fascicolo: 3, volume: 107, anno: 2001,
pagine: 548 - 553
SICI:
0091-6749(200103)107:3<548:APTTWD>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
COWS MILK ALLERGY; 1ST 3 YEARS; DOUBLE-BLIND; SKIN-PRICK; DIAGNOSTIC-ACCURACY; INFANTS; ECZEMA; HYPERSENSITIVITY; PATHOGENESIS; ADOLESCENTS;
Keywords:
allergy; atopy patch test; children; food challenge; double-blind; placebo-controlled; food challenge; skin prick test; specific IgE; positive predictive value; cow's milk; hen's egg;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Niggemann, B Humboldt Univ, Childrens Hosp Charite, Dept Paediat Pneumol &Immunol, Augustenburger Pl 1, D-13353 Berlin, Germany Humboldt Univ Augustenburger Pl 1 Berlin Germany D-13353 any
Citazione:
C.C. Roehr et al., "Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis", J ALLERG CL, 107(3), 2001, pp. 548-553

Abstract

Background: Atopic dermatitis is commonly associated with food allergy. Inaddition to skin prick tests (SPTs) and measurements of specific IgE levels, the atopy patch test (APT) has recently been introduced into the diagnostic procedure for food allergy. Objective: Our aim was to evaluate whether a combination of allergologic tests could improve the prognostic value of the individual tests for positive food challenge results. We hypothesized that the combination of a positive APT result plus proof of specific IgE, a positive SPT result, or both would render double-blind, placebo-controlled, food challenges unnecessary. Methods: One hundred seventy-three double-blind, placebo-controlled, food challenges were performed in 98 children (median age, 13 months) with atopic dermatitis. All children were subjected to SPTs, APTs, and determination of specific IgE. Sensitivity, specificity, and positive and negative predictive values were calculated. Results: Ninety-five (55%) of 173 oral provocations were assessed as positive. For evaluating suspected cow's milk (CM) allergy, the APT was the bestsingle predictive test (positive predictive value [PPV], 95%), and the combination of a positive APT result with evidence of specific IgE or an APT result together with a positive skin prick test response optimized the PPV to 100%. For hen's egg (HE) allergy, the APT was also the best single predictive test (PPV, 94%). The combination of 2 or more tests did not exceed theAPT's predictive value. In both CM and HE challenges, the predictability of oral challenges depended on the level of specific IgE. For wheat allergy,the APT proved to be the most reliable test, and the PPV of 94% could not be improved by a combination with other allergologic tests. Conclusion: The combination of positive APT results and measurement of levels of specific IgE (CRI, greater than or equal to0.35 kU/L; HE, greater than or equal to 17.5 kU/L) makes double-blind, placebo-controlled, food challenges superfluous for suspected CM and HE allergy.

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Documento generato il 26/01/21 alle ore 04:46:43