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

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.

In vitro testing for immunoglobulin E-mediated food allergies

1996 ◽  
Vol 115 (4) ◽  
pp. 312-318 ◽  
Author(s):  
Jacquelynne P. Corey ◽  
Anil Gungor
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Diagnostic Methods ◽  
Food Allergies ◽  
Vitro Assay ◽  
Positive Screen ◽  
Specific Immunoglobulin E ◽  
Radioallergosorbent Test ◽  
Specific Immunoglobulin

The role of immunoglobulin E-mediated food allergy in subjects with allergic disorders, especially in patients with rhinitis and sinusitis, is underestimated by clinicians because of the initial attribution of these disorders to immediate-type hypersensitivity reactions. The difficulties of diagnosing food-related reactions have caused further delay in their recognition and incorporation into the daily practice of diagnosing food allergy. Two of the diagnostic methods for food allergy are the in vitro assay of total immunoglobulin E and the measurement of food-specific immunoglobulin E levels in serum with the radioallergosorbent test. Measurement of specific immunoglobulin E level is the most commonly used but also one of the most controversial techniques. We examined 123 patients with rhinitis who were referred to our otolaryngology/allergy clinic between January and April 1995. All patients received an initial radioallergosorbent test screen, which included milk. We determined the positive predictive value of this positive screen and, in particular, of a positive test for milk in the diagnosis of immunoglobulin E-mediated food allergies in these patients. Conclusions were based on comparison with the result of an additional radioallergosorbent test food panel consisting of eight common and two investigational food allergens. (Otolaryngol Head Neck Surg 1996;115:312-8.)

scholarly journals Evaluation of early skin or laryngeal reaction at oral food challenge

2021 ◽  
Author(s):  
Toshinori Nakamura ◽  
Yuki Okada ◽  
Mayu Maeda ◽  
Taro Kamiya ◽  
Takanori Imai
Keyword(s):  
Prediction Models ◽  
Immunoglobulin E ◽  
Food Challenge ◽  
Serum Levels ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Specific Immunoglobulin E ◽  
Allergic Skin ◽  
Test Initiation ◽  
Skin Signs

Background: An oral food challenge (OFC) is required for diagnosing food allergies; however, uncertain reactions can impair the determination of when to stop the test. We aimed to determine the associations between immediately occurring mild allergic skin signs/laryngeal symptoms and positive OFC results. Methods: We retrospectively included children (aged 6 months to 15 years) who underwent open OFC for hen’s egg (HE), cow’s milk (CM), or wheat at a single centre between May 2012 and March 2020. Participants with mild skin signs or laryngeal symptoms at OFC initiation were classified as “skin” or “laryngeal” cases, respectively. Using logistic regression, the risk of positive OFC results, in a skin or laryngeal case, was assessed using univariate and multivariate analyses. Age, sex, total target dose, and serum levels of total and food-specific immunoglobulin E were used as covariates in prediction models. Results: In total, 2954, 1126, and 850 tests for HE, CM, and wheat, respectively, were included and comprised 115 (4%) and 25 (0.9%), 92 (9%) and 24 (2%), and 7 (1.3%) and 0 (0%) skin and laryngeal cases, respectively. Children with reactions to both HE and CM had a higher risk of a positive OFC than controls (odds ratio [95% confidence interval]: 4.6 [3.3–6.4], 2.9 [2.0–4.1] and 6.5 [3.0–10.9], 4.9 [2.2–10.9], respectively). Areas under the curves of prediction models ranged from 0.61 to 0.71. Conclusions: Uncertain reactions immediately after test initiation could not robustly predict OFC results, indicating the OFC could be continued under careful observation.

scholarly journals Prevalence of Allergic Sensitization to Conifer Pollen in a High Cypress Exposure Area

2016 ◽  
Vol 7 (4) ◽  
pp. ar.2016.7.0183 ◽  
Author(s):  
Javier Domínguez-Ortega ◽  
María Ángeles López-Matas ◽  
María Dolores Alonso ◽  
Angélica Feliu ◽  
Javier Ruiz-Hornillos ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Allergic Sensitization ◽  
Positive Skin Prick Test ◽  
Serum Samples ◽  
Positive Skin ◽  
Prick Test ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Positive Results

Background Sensitization to Finales (Cupressaceae and Pinaceae) has increased dramatically in recent years. The prevalence of sensitization in different geographic areas is related to exposure to specific pollens. Objectives To investigate the prevalence of allergy to different conifer pollens, describe the characteristics of patients with such allergy, and identify the involved allergens. Methods Patients were recruited at five hospitals near Madrid. Extracts from conifer pollen were prepared and used in skin-prick testing. Wheal sizes were recorded, and serum samples obtained from patients with positive reactions to Cupressus arizonica and/or Pinus pinea. The specific immunoglobulin E value to C. arizonica and Cup a 1 was determined. Individual immunoblots for each patient and with a pool of sera were performed. Allergenic proteins were sequenced by using liquid chromatography-tandem mass spectrometry. Results Of 499 individuals included in the study, 17 (14%) had positive skin-prick test results to some conifer pollen extracts. Sixty-four patients had positive results to C. arizonica (prevalence 12.8%) and 11 had positive results to P. pinea (2.2%). All the patients had respiratory symptoms (61.4% during the C. arizonica pollination period), and 62.9% had asthma. Approximately 86% of the patients had positive specific immunoglobulin E results to C. arizonica and 923% had positive results to Cup a 1. Fourteen different bands were recognized by immunoblot; the most frequent bands were those detected at 43, 18, 16, and 14 kDa. All sequenced proteins corresponded to Cup a 1. Conclusion Allergy to conifer pollen could be considered a relevant cause of respiratory allergy in central Spain. Asthma was more frequent than in other studies. We only identified Cup a 1 as involved in sensitization.

scholarly journals Increasing specific immunoglobulin E levels correlate with the risk of anaphylaxis during an oral food challenge

2018 ◽  
Vol 29 (4) ◽  
pp. 417-424 ◽  
Author(s):  
Noriyuki Yanagida ◽  
Sakura Sato ◽  
Kyohei Takahashi ◽  
Ken-ichi Nagakura ◽  
Tomoyuki Asaumi ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

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

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0135 ◽  
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.

scholarly journals Legume and sesame oral food challenge outcomes

2021 ◽  
Vol 3 (2) ◽  
pp. 42-49 ◽  
Author(s):  
Jacob J. Pozin ◽  
Ashley L. Devonshire ◽  
Kevin Tom ◽  
Melanie Makhija ◽  
Anne Marie Singh
Keyword(s):  
Regression Models ◽  
Operating Characteristic ◽  
Immunoglobulin E ◽  
Gastrointestinal Symptoms ◽  
Food Challenge ◽  
Logistic Regression Models ◽  
Receiver Operating Characteristic Curves ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Food Challenges

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.

scholarly journals Diagnosing Environmental Allergies: Comparison of Skin-Prick, Intradermal, and Serum Specific Immunoglobulin E Testing

2017 ◽  
Vol 8 (2) ◽  
pp. ar.2017.8.0194 ◽  
Author(s):  
Denisa Ferastraoaru ◽  
Maria Shtessel ◽  
Elizabeth Lobell ◽  
Golda Hudes ◽  
David Rosenstreich ◽  
...  
Keyword(s):  
New York ◽  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Skin Testing ◽  
Allergic Sensitization ◽  
Test Results ◽  
Specific Immunoglobulin E ◽  
Modern Methods ◽  
Specific Immunoglobulin ◽  
Exposure History

Background Allergists commonly perform intradermal skin testing (IDST) after negative skin-prick testing (SPT) to comprehensively diagnose environmental allergic sensitization. However, with the availability of modern methods to detect serum-specific immunoglobulin E (ssIgE), it is unclear if ssIgE testing could substitute for IDST. Objective To determine the efficacy of ssIgE testing and IDST when added to SPT in diagnosing environmental allergic sensitizations. Methods SPT, IDST, and ssIgE testing to nine common environmental allergens were analyzed in 75 patients with oculonasal symptoms who presented to our allergy clinics in the Bronx, New York, between January 2014 and May 2015. Results A total of 651 SPT and 499 ssIgE tests were independently performed and revealed 162 (25%) and 127 (25%) sensitizations, respectively. When SPT results were negative, IDST results revealed 108 of 452 additional sensitizations (24%). In contrast, when SPT results were negative, ssIgE test results only revealed 9% additional sensitizations. When both SPT and IDST results were negative, ssIgE testing only detected 3% of additional sensitizations, and ssIgE levels were typically low in these cases (median, 1.25 kU/L; range, 0.357–4.47 kU/L). When both SPT and ssIgE test results were negative, IDST results detected 15% additional sensitizations. Conclusion IDST detected more additional environmental sensitizations compared with ssIgE testing. IDST, therefore, may be useful when the SPT and/or ssIgE testing results were negative, but the exposure history indicated relevant allergic sensitization. Serology added only a little more information if both SPT and IDST results were negative but may be useful in combination with SPT if IDST cannot be performed.

scholarly journals Latex Sensitization

2011 ◽  
Vol 114 (3) ◽  
pp. 565-569 ◽  
Author(s):  
Gaetano Draisci ◽  
Bruno A. Zanfini ◽  
Eleonora Nucera ◽  
Stefano Catarci ◽  
Raffaella Sangregorio ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Enzyme Immunoassay ◽  
Immunoglobulin E ◽  
Latex Allergy ◽  
Gynecologic Surgery ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Group A ◽  
Skin Prick Tests ◽  
Group B

Background Previous studies have reported a greater frequency of sensitization to latex in the female population and a higher incidence of anaphylactic reactions to latex during cesarean section. In this study, the authors investigated the prevalence of latex sensitization in obstetric patients compared with nonpregnant subjects. Methods Two hundred ninety-four healthy pregnant women who were at term with a singleton fetus and scheduled for caesarean section (group A) were compared with 294 healthy nulliparous women with childbirth potential undergoing gynecologic surgery (group B). Before surgery, patients completed a questionnaire, and venous blood samples were collected to measure specific immunoglobulin E serum concentrations with a fluorescent enzyme immunoassay test. Skin-prick tests were performed if adverse reactions occurred during surgery. Latex allergy was diagnosed on the basis of immunoglobulin E results and/or positive skin-prick tests. Results The prevalence of latex sensitization was higher in group A than in group B (15/294, 5.1% vs. 5/294, 1.7%; P &lt; 0.05). A significant difference in specific immunoglobulin E serum concentration was noted between pregnant and nonpregnant patients who had a positive fluorescent enzyme immunoassay test (median serum concentration: 1.93 kilounits/l; interquartile range = 2.28 vs. 0.78 kilounits/l; interquartile range = 1.07; P less than 0.05). Two patients in group A experienced an anaphylactic reaction to latex. Statistical analysis disclosed no association between latex sensitization and accepted risk factor for latex allergy. Conclusions The authors report a higher prevalence of latex sensitization in the obstetric population than in nonpregnant subjects undergoing gynecologic surgery.

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