The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy - 15/08/11
, Magnus Rudengren, BSc b, Staffan Ahlstedt, PhD b, c, S.A. Bock, MD d, Hugh A. Sampson, MD a
Reprint requests: Jennifer M. Maloney, MD, Mount Sinai Hospital, Department of Pediatrics, Division of Allergy and Immunology, Box 1198, One G. Levy Place, New York, NY 10029.Abstract |
Background |
The gold standard for diagnosing food allergy is the double-blind, placebo-controlled food challenge. Diagnostic food-specific IgE levels might assist in diagnosing food allergies and circumventing the need for food challenges.
Objectives |
The purpose of this study was to determine the utility of food-specific IgE measurements for identifying symptomatic peanut, tree nut, and seed allergies and to augment what is known about the relationships among these foods.
Methods |
Patients referred for suspected peanut or tree nut allergies answered a questionnaire about their perceived food allergies. Allergen-specific diagnoses were based on questionnaire, medical history, and, when relevant, skin prick tests and serum specific IgE levels. Sera from the patients were analyzed for specific IgE antibodies to peanuts, tree nuts, and seeds by using ImmunoCAP Specific IgE (Phadia, Inc, Uppsala, Sweden).
Results |
Three hundred twenty-four patients (61% male; median age, 6.1 years; range, 0.2-40.2 years) were evaluated. The patients were highly atopic (57% with atopic dermatitis and 58% with asthma). The majority of patients with peanut allergy were sensitized to tree nuts (86%), and 34% had documented clinical allergy. The relationship between diagnosis and allergen-specific IgE levels were estimated by using logistic regression. Diagnostic decision points are suggested for peanut and walnut. Probability curves were drawn for peanut, sesame, and several tree nuts. High correlations were found between cashew and pistachio and between pecan and walnut.
Conclusions |
Quantification of food-specific IgE is a valuable tool that will aid in the diagnosis of symptomatic food allergy and might decrease the need for double-blind, placebo-controlled food challenges.
Le texte complet de cet article est disponible en PDF.Key words : Food allergy, peanut allergy, tree nut allergy, serum-specific IgE
Plan
| Supported in part by a grant from Phadia and in part by a GCRC grant. |
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| Disclosure of potential conflict of interest: J. M. Maloney has declared that she has no conflict of interest. M. Rudengren and S. Ahlstedt are employed by Phadia. S. A. Bock is employed by Boulder Valley Asthma and Allergy Clinic and is on the speakers’ bureau for Dey Pharmaceuticals. H. A. Sampson has consulting arrangements with Allertein and Pioneer International, has received research support from Phadia, and has served as a member of the American Academy of Allergy, Asthma & Immunology, the Food Allergy and Anaphylaxis Network Medical Advisory Board, and the Food Allergy Initiative Scientific Advisory Board. |
Vol 122 - N° 1
P. 145-151 - juillet 2008 Retour au numéro
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