Food allergy, dermatologic diseases, and anaphylaxisDiagnosing peanut allergy with skin prick and specific IgE testing
Section snippets
Subjects
Data from all food challenges to peanut at St Mary's Hospital were included in the study. Subjects undergoing challenges either were referred from the pediatric allergy clinic at St Mary's Hospital with suspected food allergy (January 1995 to July 2000) or were subjects from a large cross-sectional birth cohort (Avon Longitudinal Study of Parents and Children [ALSPAC]11) with a positive skin prick test result and either a possible previous reaction or no history of having consumed the food (May
Skin prick testing
A total of 157 subjects underwent 161 peanut challenges (Table I). Skin prick testing data were available for 135 (83.9%) challenges (Table I). There were no clinical or demographic differences between children with and without skin prick test data (Table I). The median time between skin prick testing and challenge was 1.7 (interquartile range, 0-7.2) months. The positive predictive value for clinical allergy of a wheal diameter of at least 8 mm was 94.4% (95% CI, 72.7% to 99.9%) with a
Discussion
Previous studies have suggested that the magnitude of a skin prick test or specific IgE result can improve the diagnostic utility of these tests.4, 5, 6, 13 We have presented data from a group of more than 100 children from both an allergy clinic and a community sample that demonstrate that a skin prick test ≥ 8 mm or a specific IgE ≥ 15 kUA/L have a high predictive value for clinical peanut allergy. With this high cutoff value, both the negative predictive value and sensitivity of the test
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Supported by the Food Standards Agency (project T07001).