Skin prick test to egg white provides additional diagnostic utility to serum egg white–specific IgE antibody concentration in children - 17/08/11
Reprint requests: Anna Nowak-Wegrzyn, MD, Pediatric Allergy and Immunology, Department of Pediatrics, Box 1198, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029.New York, NY
Abstract |
Background |
Levels of IgE antibody to egg white of greater than 7 kIU/L are highly predictive of clinical reactivity to egg, and lower levels often require evaluation with oral food challenge (OFC) to establish definitive diagnosis. OFCs have inherent risks, and diagnostic criteria indicating high likelihood of passing would be clinically useful.
Objective |
We sought to determine whether the size of the skin prick test (SPT) to egg white adds diagnostic utility for children with low egg white–specific IgE antibody levels.
Methods |
A retrospective analysis of clinical history, egg white–specific IgE antibody levels, SPT responses, and egg OFC outcomes was performed.
Results |
Children who passed (n = 29) egg OFCs and those who failed (n = 45) did not differ significantly in age, clinical characteristics, or egg white–specific IgE levels. There were, however, significant differences between both egg white SPT wheal response size and egg/histamine SPT wheal index. Children who failed egg OFCs had a median wheal of 5.0 mm; those who passed had a median wheal of 3.0 mm (P = .003). Children who failed egg OFCs had a median egg/histamine index of 1.00; those who passed had a median index of 0.71 (P = .001). For egg white–specific IgE levels of less than 2.5 kIU/L, an SPT wheal of 3 mm or an egg/histamine index of 0.65 was associated with a 50% chance of passing.
Conclusion |
In children with low egg white–specific IgE levels, those with smaller SPT wheal responses to egg were more likely to pass an egg OFC than those with larger wheal responses. The size of the egg white SPT response might provide additional information to determine the timing of egg OFC.
Clinical implications |
The size of the egg white SPT wheal response might provide the clinician with additional information to determine the timing of egg OFC in children with low egg white–specific IgE antibody levels.
Le texte complet de cet article est disponible en PDF.Key words : Egg allergy, food allergy, oral food challenge, skin prick test
Abbreviations used : DBPCFC, OFC, SPT
Plan
| Supported in part by a grant (MO1-RR-00071) awarded to the Mount Sinai School of Medicine from the National Institutes of Health and by the American Academy of Allergy, Asthma and Immunology Clinical Fellowship Award to Dr Adina Kay Knight. Disclosure of potential conflict of interest: The authors have declared they have no conflict of interest. |
Vol 117 - N° 4
P. 842-847 - avril 2006 Retour au numéro
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