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