Use of Specific IgE and Skin Prick Test to Determine Clinical Reaction Severity

Ta, Von and Weldon, Brittany and Yu, Grace and Humblet, Olivier and Neale-May, Susan and Nadeau, Kari (2011) Use of Specific IgE and Skin Prick Test to Determine Clinical Reaction Severity. British Journal of Medicine and Medical Research, 1 (4). pp. 410-429. ISSN 22310614

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Abstract

Aims: To determine whether specific IgE and skin prick test correlate better in predicting reaction severity during a double-blinded placebo controlled food challenge (DBPCFC) for egg, milk, and multiple tree nut allergens.
Study design: Prospective study.
Place and Duration of Study: Department of Pediatrics, Stanford University School of Medicine, August 2009 and ongoing.
Methodology: We examined the reaction severity of twenty-four subjects to nine possible food allergens: milk, egg, almond, cashew, hazelnut, peanut, sesame, pecan and walnut. Specific IgE and SPT were performed before each DBPCFC. DBPCFC results were classified into mild (1), moderate (2), or severe (3) reactions using a modified Bock’s criteria.
Results: Twenty four subjects underwent a total of 80 DBPCFC. Eighty percent of all DBPCFCs resulted in a positive reaction. A majority, 71%, were classified as mild. No reactions occurred with a SPT of zero mm while three reactions occurred with a negative specific IgE. All reactions were reversible with medication.
Conclusion: These data suggest that SPT and specific IgE levels are not associated with reaction severity (p<0.64 and 0.27, respectively). We also found that combining specific IgE and SPT improved specificity but did not help to achieve clinically useful sensitivity. For instance, an SPT > 5mm had a sensitivity of 91% and specificity of 50%. Combining SPT > 5mm and IgE > 7 resulted in a reduced sensitivity of 64%. Unexpectedly, a history of anaphylaxis 70% (n=17) was not predictive of anaphylaxis on challenge 4% (n=2).

Item Type: Article
Subjects: Archive Paper Guardians > Medical Science
Depositing User: Unnamed user with email support@archive.paperguardians.com
Date Deposited: 01 Jul 2023 11:03
Last Modified: 19 Jan 2024 11:49
URI: http://archives.articleproms.com/id/eprint/1347

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