Quantification of specific IgE to whole peanut extract and peanut components in prediction of peanut allergy

University of Manchester, Manchester Academic Health Science Centre, NIHR Translational Research Facility in Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom.
The Journal of allergy and clinical immunology (Impact Factor: 11.25). 03/2011; 127(3):684-5. DOI: 10.1016/j.jaci.2010.12.012
Source: PubMed
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    • "We did not reproduce the results seen by Nicalou et al. Their study also used a specific IgE cutoff of 15 kU/L but had 96% of subjects at greater than this level being correctly classified as allergic while we only demonstrated a correct diagnosis of 48% (31 with IgE > 15 kU/L of 64 that had a reaction) (Nicalou, 2011 "
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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).
    01/2011; 1(4):410-429.
  • The Journal of allergy and clinical immunology 03/2011; 127(3):555-7. DOI:10.1016/j.jaci.2011.01.029 · 11.25 Impact Factor
  • The Journal of allergy and clinical immunology 03/2011; 127(3):631-2. DOI:10.1016/j.jaci.2011.01.026 · 11.25 Impact Factor
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