Legume and sesame oral food challenge outcomes

Background: Legume and sesame are emerging food allergens. The utility of specific immunoglobulin E (sIgE) testing to predict clinical reactivity to these allergens is not well described. Objective: To describe clinical outcomes and sIgE in sesame and legume oral food challenges (OFC). Methods: We performed a retrospective review of 74 legume and sesame OFCs between 2007 and 2017 at the Ann and Robert H. Lurie Children’s Hospital of Chicago. Clinical data, OFC outcome, and sIgE to legume and sesame were collected. Receiver operating characteristic curves and logistic regression models that predicted OFC outcome were generated. Results: Twenty-eight patients (median age, 6.15 years) passed legume OFC (84.9%), and 25 patients (median age, 5.91 years) passed sesame OFC (61.0%). The median sIgE to legume was 1.41 kUA/L and, to sesame, was 2.34 kUA/L. In patients with failed legume OFC, 60.0% had cutaneous symptoms, 20.0% had gastrointestinal symptoms, and 20.0% had anaphylaxis. Of these reactions, 80.0% were controlled with antihistamine alone and 20.0% required epinephrine. In patients for whom sesame OFC failed, 50.0% had cutaneous symptoms, 12.5% had gastrointestinal symptoms, and 37.50% had anaphylaxis. Of these reactions, 6.3% required epinephrine, 31.3% were controlled with diphenhydramine alone, and 63.50% required additional epinephrine or prednisone. Conclusion: Most OFCs to legumes were passed and reactions to failed legume OFCs were more likely to be nonsevere. Sesame OFC that failed was almost twice as likely compared with legume OFC that failed, and reactions to sesame OFC that failed were often more severe. Sesame sIgE did not correlate with OFC outcome.

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Legume and Sesame Oral Food Challenge Outcomes

10.21203/rs.3.rs-113278/v1 ◽

2020 ◽

Author(s):

Jacob J. Pozin ◽

Ashley L. Devonshire ◽

Kevin Tom ◽

Melanie Makhija ◽

Anne Marie Singh

Keyword(s):

Logistic Regression ◽

Regression Models ◽

Operating Characteristic ◽

Food Challenge ◽

Specific Ige ◽

Oral Food Challenge ◽

Food Allergens ◽

Logistic Regression Models ◽

Receiver Operating Characteristic Curves ◽

Food Challenges

Abstract Background: Legume and sesame are emerging food allergens. The utility of specific IgE testing (sIgE) to predict clinical reactivity to these allergens is not well described.Objective: To describe clinical outcomes and sIgE in sesame and legume OFCs. Methods: We performed a retrospective review of 74 legume and sesame oral food challenges (OFC) performed between 2007-2017 at the Ann & Robert H. Lurie Children’s Hospital of Chicago. Clinical data, OFC outcome, and sIgE to legume and sesame were collected. Receiver operating characteristic curves (ROC) and logistic regression models predicting OFC outcome were generated. Results: Twenty-eight patients (median age 6.15 years) passed legume OFC (84.85%), and twenty-five patients (median age 5.91 years) passed sesame OFC (60.98%). The median sIgE to legume was 1.41 kUa/L, and 2.34 kUa/L, to sesame. For patients who failed legume OFC, 67% had cutaneous, 16.5% had gastrointestinal, and 16.5% had anaphylaxis. Of these reactions, 80% were controlled with Benadryl alone and 20% required epinephrine. For patients who failed sesame OFC, 53% had cutaneous, 12% had gastrointestinal, and 35% had anaphylaxis. Of these reactions, 6% required epinephrine, 31% were controlled with Benadryl alone, and 63% required additional epinephrine or steroids. Conclusion: Most OFC to legumes were passed and reactions to failed legume OFCs were more likely to be non-severe. Failing an OFC to sesame was almost twice as likely compared to failing a legume OFC, and reactions to failed sesame OFC were often more severe. Sesame sIgE did not correlate with OFC outcome.

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Ovomucoid Specific Immunoglobulin E as a Predictor of Tolerance to Cooked Egg

Allergy & Rhinology ◽

10.2500/ar.2015.6.0135 ◽

2015 ◽

Vol 6 (3) ◽

pp. ar.2015.6.0135 ◽

Cited By ~ 6

Author(s):

Lisa M. Bartnikas ◽

William J. Sheehan ◽

Katherine L. Tuttle ◽

Carter R. Petty ◽

Lynda C. Schneider ◽

...

Keyword(s):

Operating Characteristic ◽

Immunoglobulin E ◽

Characteristic Curve ◽

Food Challenge ◽

Spearman Correlation ◽

Sige Level ◽

Hen’S Egg ◽

Significant Difference ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin

Background Ovomucoid is the dominant allergen in hen's egg. Although several studies evaluated the utility of ovomucoid specific immunoglobulin E (sIgE) levels in predicting baked (e.g., muffin or cupcake) or raw egg food challenge outcomes, studies that evaluated ovomucoid sIgE as a predictor of cooked egg (e.g., scrambled or hard boiled) challenge outcomes are limited. Objective To determine the relation of ovomucoid sIgE levels with cooked egg food challenge outcomes. Methods A retrospective review of 44 children who underwent cooked egg food challenge and who had the ovomucoid sIgE level measured. Results Thirty-six of 44 children (81.8%) passed cooked egg challenge. The ovomucoid sIgE level predicted cooked egg challenge outcome (passed median, <0.35 kU/L [range, <0.35–0.64 kU/L]; failed median, 0.40 kU/L [range, <0.35–3.13 kU/L]; p = 0.004). Ovomucoid sIgE levels correlated with egg white (EW) sIgE levels (Spearman correlation coefficient, 0.588; p = 0.001). Receiver operating characteristic curve analysis of ovomucoid and EW sIgE demonstrated areas under the curve of 0.711 and 0.766, respectively. No significant difference was observed among those immunologic parameters in their abilities to predict cooked egg challenge outcome (p = 0.559). Conclusion The ovomucoid sIgE level may be helpful in predicting cooked egg challenge outcomes. However, our study did not support a role for ovomucoid sIgE replacing EW sIgE testing in evaluating egg allergy.

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The diagnosis of Brazil nut allergy using history, skin prick tests, serum-specific immunoglobulin E and food challenges

Clinical & Experimental Allergy ◽

10.1111/j.1365-2222.2006.02426.x ◽

2006 ◽

Vol 36 (2) ◽

pp. 226-232 ◽

Cited By ~ 15

Author(s):

S. Ridout ◽

S. Matthews ◽

C. Gant ◽

R. Twiselton ◽

T. Dean ◽

...

Keyword(s):

Immunoglobulin E ◽

Brazil Nut ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin ◽

Skin Prick Tests ◽

Food Challenges

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Result-related factors, safety, and reliability of egg-specific immunoglobulin E in the oral food challenge with lightly heated whole egg -A retrospective study of 227 cases-

Nihon Shoni Arerugi Gakkaishi The Japanese Journal of Pediatric Allergy and Clinical Immunology ◽

10.3388/jspaci.35.220 ◽

2021 ◽

Vol 35 (3) ◽

pp. 220-227

Author(s):

Masaaki Doi ◽

Yasutaka Matsubara ◽

Nayu Iwakoshi ◽

Kumiko Takagi ◽

Aya Sasaki ◽

...

Keyword(s):

Retrospective Study ◽

Immunoglobulin E ◽

Food Challenge ◽

Oral Food Challenge ◽

Related Factors ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin ◽

Safety And Reliability ◽

Whole Egg

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Skin Prick Tests and Patch Tests in Children with Food Allergies.

10.46940/sjnp.02.1006 ◽

2020 ◽

pp. 1-4

Keyword(s):

Immunoglobulin E ◽

Skin Prick Testing ◽

Food Challenge ◽

Diagnostic Methods ◽

Food Allergies ◽

Sufficient Evidence ◽

Patch Tests ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin ◽

Skin Prick Tests

Abstract Diagnosing food allergies can be challenging for patients and health professionals. Standard diagnostic methods include skin prick testing, food-specific immunoglobulin E (IgE) and oral food challenge. There is no scientifically sufficient evidence for routine use of patch testing for food allergy evaluation in children.

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MILK-SPECIFIC IMMUNOGLOBULIN E/TOTAL IMMUNOGLOBULIN E RATIO AS A PREDICTOR OF POSITIVE ORAL FOOD CHALLENGES IN CHILDREN WITH ALLERGY TO COW'S MILK

PEDIATRICS ◽

10.1542/peds.2007-2022j ◽

2008 ◽

Vol 121 (Supplement 2) ◽

pp. S92.2-S92

Author(s):

George Konstantinou ◽

Alexandra Kalobatsou ◽

Maria Koutli ◽

Paraskevi Xepapadaki ◽

Nikolaos Douladiris ◽

...

Keyword(s):

Immunoglobulin E ◽

Cow’S Milk ◽

Cow's Milk ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin ◽

Food Challenges ◽

Total Immunoglobulin

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Is Ara h 2 indeed the best predictor for peanut allergy in Dutch children?

Diagnosis ◽

10.1515/dx-2015-0032 ◽

2016 ◽

Vol 3 (1) ◽

pp. 31-35 ◽

Cited By ~ 3

Author(s):

Mirjam Schots ◽

Amerik C. de Mol ◽

Henricus J. Vermeer ◽

Yvonne M. Roosen ◽

Aldonse W. Vriesman

Keyword(s):

Prediction Model ◽

Peanut Allergy ◽

Immunoglobulin E ◽

Food Challenge ◽

Discriminative Ability ◽

Double Blind ◽

Ara H 2 ◽

Receiver Operating Characteristic Curves ◽

Specific Immunoglobulin E ◽

Predicting Factor

AbstractSpecific immunoglobulin E to Ara h 2 (sIgE to Ara h 2) is described as an upcoming predicting factor for diagnosing peanut allergy in children. The gold standard for diagnosing peanut allergy is a double blind placebo controlled food challenge, however this is time consuming and potentially harmful. We investigate Ara h 2 as a preliminary less invasive diagnostic tool for diagnosing peanut allergy in a general population of peanut sensitized children.Children (n=52) with peanut sensitization were retrospectively included. An oral food challenge (OFC) confirmed peanut allergy or tolerance, as primary outcome. Individual candidate predictors were identified by univariate regression analysis and used in a prediction model. Different cut-off values were obtained and receiver operating characteristic curves were plotted.Multivariate analyses resulted in Ara h 2 as best predictor, with a discriminative ability of 0.87 (95% confidence interval, 0.77–0.97). Sensitivity and specificity of 55% and 95%, respectively, were found for a sIgE to Ara h 2 cut-off value of 4.25 kU/L. The highest positive predictive value of 100% was reached at 5.61 kU/L. No absolute relation was found between the value of Ara h 2 and the severity of the reaction during OFC.This study developed a prediction model in which sIgE to Ara h 2 was the best predictor for peanut allergy in sensitized children in a general hospital. Therefore depending on the history and the Ara h 2 results, an OFC is not always needed to confirm the diagnosis.

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