Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg
Authors: Cortot, Catherine F.; Sheehan, William J.; Permaul, Perdita; Friedlander, James L.; Baxi, Sachin N.; Gaffin, Jonathan M.; Dioun, Anahita F.; Hoffman, Elaine B.; Schneider, Lynda C.; Phipatanakul, Wanda
Source: Allergy and Asthma Proceedings, Volume 33, Number 3, May/June 2012 , pp. 275-281(7)
Publisher: OceanSide Publications, Inc
Abstract:Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white-specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2-18 years, receiving an egg white-specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0-35 mm) for passed challenges and 17 mm (range, 10-30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white-specific IgE was 2.02 kU/L (range, <0.35-13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51-6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white-specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white-specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size.
Document Type: Research article
Publication date: 2012-05-01
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- By this author: Cortot, Catherine F. ; Sheehan, William J. ; Permaul, Perdita ; Friedlander, James L. ; Baxi, Sachin N. ; Gaffin, Jonathan M. ; Dioun, Anahita F. ; Hoffman, Elaine B. ; Schneider, Lynda C. ; Phipatanakul, Wanda