Sesame allergy: Role of specific IgE and skin-prick testing in predicting food challenge results

Authors: Permaul, Perdita; Stutius, Lisa M.; Sheehan, William J.; Rangsithienchai, Pitud; Walter, Jolan E.; Twarog, Frank J.; Young, Michael C.; Scott, Jordan E.; Schneider, Lynda C.; Phipatanakul, Wanda

Source: Allergy and Asthma Proceedings, Volume 30, Number 6, November/December 2009 , pp. 643-648(6)

Publisher: OceanSide Publications, Inc

Buy & download fulltext article:

Price: $39.50 plus tax (Refund Policy)

Abstract:

There are conflicting data regarding the diagnostic value of sesame-specific IgE and sesame skin test. Currently, there are no established thresholds that predict clinical reactivity. We examined the correlation of sesame ImmunoCAP and skin-prick test (SPT) results with oral challenge outcomes in children suspected of having a sesame food allergy. We conducted a retrospective chart review of children, aged 2-12 years, receiving a sesame ImmunoCAP level, SPT, and food challenge from January 2004 to August 2008 at Children's Hospital Boston and affiliated allergy clinics. Food challenges were conducted in cases of questionable clinical history or a negative ImmunoCAP and/or negative SPT despite a convincing history. Thirty-three oral sesame challenges were conducted. Of the 33 challenges performed, 21% (n = 7) failed and 79% (n = 26) passed. A sesame-specific IgE level of ≥7 kU_A/L showed specificity of >90%. An SPT wheal size of ≥6 mm showed specificity of >90%. Receiver operator characteristic (ROC) curve analysis for sesame-specific IgE revealed an area under the curve (AUC) of 0.56. ROC curve analysis for SPT wheal size revealed an AUC of 0.67. To our knowledge, this study represents the largest number of sesame challenges performed to evaluate the diagnostic value of both sesame-specific IgE and SPT. Based on our sample, both tests are not good predictors of true sesame allergy as determined by an oral challenge. We were unable to establish a threshold with a 95% positive predictive value for both sesame-specific IgE and SPT.

Keywords: Food allergy; food challenge; IgE; ImmunoCAP; oral challenge; sesame allergy; sesame skin test; skin-prick test

Document Type: Research article

DOI: http://dx.doi.org/10.2500/aap.2009.30.3294

Affiliations: 1: Department of Medicine, Division of Allergy and Immunology, Children's Hospital Boston, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA

Publication date: 2009-11-01

More about this publication?

Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

Articles marked "F" offer free full text for personal noncommercial use only.

The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
Editorial Board
Information for Authors
Submit a Paper
Information for Advertisers
Reprint Requests
ingentaconnect is not responsible for the content or availability of external websites

Sesame allergy: Role of specific IgE and skin-prick testing in predicting food challenge results

Buy & download fulltext article:

Tools

Key

Text size:

Useful pages