Food and Drug Reactions and AnaphylaxisUtility of food-specific IgE concentrations in predicting symptomatic food allergy☆,☆☆
Section snippets
Study population
One hundred consecutive children and adolescents referred to the Johns Hopkins Pediatric Allergy Clinic for evaluation of suspected IgE-mediated food hypersensitivity were enrolled in the study. Patients ranged in age from 3 months to 14 years (median, 3.8 years), and the majority were boys (male/female = 62:38). Sixty-one percent of patients had atopic dermatitis, approximately one half had asthma, and about 90% came from atopic families. Evaluation consisted of an extensive history, physical
Results
One hundred children and adolescents with suspected food allergy were enrolled in the study. The diagnosis of food hypersensitivity was based on the outcome of DBPCFCs, a convincing history of clinical reactivity, or a suggestive history of reactivity with a food-specific IgE level that exceeded the previously established 95% decision points. As shown in Table I, the prevalence rates of allergic reactivity to individual foods in the prospective study compared with prevalence rates in the
Discussion
A number of studies have confirmed the poor positive predictive value of patient history and skin prick test and RAST results in the diagnosis of symptomatic IgEmediated food hypersensitivity.2, 12, 15, 17, 18 However, a number of studies have confirmed that negative skin prick test responses have excellent negative predictive values for excluding the presence of IgE-mediated food allergy.11, 14, 17 Consequently, the DBPCFC has become the gold standard for the diagnosis of food allergy, with
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Supported in part by a grants from Pharmacia/Upjohn Diagnostics, the National Institutes of Health Division of Research Resources grant MO1 RR00052, and the National Institute of Allergy & Infectious Disease, National Institutes of Health grant AI-24439.
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Reprint requests: Hugh A. Sampson, MD, Department of Pediatrics; Box 1090, The Jaffe Institute of Food Allergy, The Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574.