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Outcome of double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis.
Clin Exp Allergy 1999; 29(1):91-6CE

Abstract

BACKGROUND AND OBJECTIVE

Little is known about late phase clinical reactions during oral food challenges and the value of specific IgE in terms of sensitivity and specificity.

METHODS

We therefore analysed retrospectively the clinical outcome of 387 oral provocations during double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis.

RESULTS

Eighty-seven (81%) children showed a positive clinical reaction to at least one challenge. The vast majority of children (94%) showed clinical symptoms to one or two allergens. One hundred and thirty-one of 259 (51%) of verum challenges and 1/128 (0.8%) placebo challenge were assessed as positive. Oral provocations with hen's egg showed the highest percentage of positive reactions (70%). Sensitivity of specific IgE to the four allergens tested was 90%, specificity 30%. Sensitivity of the parental history as a predictive factor was 48%, specificity 72%. Ninety-two of 131 (70%) children with positive verum provocations showed early reactions, 33 (25%) late and six (5%) combined early and late reactions. In 84/131 (64%) positive provocations one organ system was involved, while in 44 (34%) provocations two and in three (2%) challenges three organ systems were involved. Skin reactions were the most frequent clinical manifestation leading to positive reactions followed by gastro-intestinal and respiratory symptoms. There was no correlation between titration dose and specific IgE. The subgroup of non-sensitized children did not differ in terms of sex, age or titration dose from the total study population.

CONCLUSION

Double-blind, placebo-controlled oral food challenges are helpful in distinguishing children with clinically manifested symptoms from those with food sensitization. Accurately identifying children with a clinical relevant food allergy may help to prescribe specific diets on a scientific basis, avoiding dietary limitations which may be unnecessary or even harmful.

Authors+Show Affiliations

University Children's Hospital, Berlin, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10051707

Citation

Niggemann, B, et al. "Outcome of Double-blind, Placebo-controlled Food Challenge Tests in 107 Children With Atopic Dermatitis." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 29, no. 1, 1999, pp. 91-6.
Niggemann B, Sielaff B, Beyer K, et al. Outcome of double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis. Clin Exp Allergy. 1999;29(1):91-6.
Niggemann, B., Sielaff, B., Beyer, K., Binder, C., & Wahn, U. (1999). Outcome of double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 29(1), pp. 91-6.
Niggemann B, et al. Outcome of Double-blind, Placebo-controlled Food Challenge Tests in 107 Children With Atopic Dermatitis. Clin Exp Allergy. 1999;29(1):91-6. PubMed PMID: 10051707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis. AU - Niggemann,B, AU - Sielaff,B, AU - Beyer,K, AU - Binder,C, AU - Wahn,U, PY - 1999/3/3/pubmed PY - 1999/3/3/medline PY - 1999/3/3/entrez SP - 91 EP - 6 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 29 IS - 1 N2 - BACKGROUND AND OBJECTIVE: Little is known about late phase clinical reactions during oral food challenges and the value of specific IgE in terms of sensitivity and specificity. METHODS: We therefore analysed retrospectively the clinical outcome of 387 oral provocations during double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis. RESULTS: Eighty-seven (81%) children showed a positive clinical reaction to at least one challenge. The vast majority of children (94%) showed clinical symptoms to one or two allergens. One hundred and thirty-one of 259 (51%) of verum challenges and 1/128 (0.8%) placebo challenge were assessed as positive. Oral provocations with hen's egg showed the highest percentage of positive reactions (70%). Sensitivity of specific IgE to the four allergens tested was 90%, specificity 30%. Sensitivity of the parental history as a predictive factor was 48%, specificity 72%. Ninety-two of 131 (70%) children with positive verum provocations showed early reactions, 33 (25%) late and six (5%) combined early and late reactions. In 84/131 (64%) positive provocations one organ system was involved, while in 44 (34%) provocations two and in three (2%) challenges three organ systems were involved. Skin reactions were the most frequent clinical manifestation leading to positive reactions followed by gastro-intestinal and respiratory symptoms. There was no correlation between titration dose and specific IgE. The subgroup of non-sensitized children did not differ in terms of sex, age or titration dose from the total study population. CONCLUSION: Double-blind, placebo-controlled oral food challenges are helpful in distinguishing children with clinically manifested symptoms from those with food sensitization. Accurately identifying children with a clinical relevant food allergy may help to prescribe specific diets on a scientific basis, avoiding dietary limitations which may be unnecessary or even harmful. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/10051707/Outcome_of_double_blind_placebo_controlled_food_challenge_tests_in_107_children_with_atopic_dermatitis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0954-7894&date=1999&volume=29&issue=1&spage=91 DB - PRIME DP - Unbound Medicine ER -