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The atopy patch test (APT)-- a useful tool for the diagnosis of food allergy in children with atopic dermatitis.
Allergy 2000; 55(3):281-5A

Abstract

BACKGROUND

While immediate-type clinical reactions to food can quite easily be identified by history or measurement of specific IgE in combination with positive oral food challenges, the evaluation of food allergy in the absence of immediate clinical reactions still presents diagnostic difficulties--particularly in children with atopic dermatitis. The objective of this study was to evaluate the diagnostic value of the atopy patch test (APT) with regard to late-phase reactions observed in double-blind, placebo-controlled food challenges with cow's milk, hen's egg, wheat, and soybean.

METHODS

We investigated 75 children (median age 2.1 years) with suspected food allergy by double-blind, placebo-controlled food challenges, specific IgE in serum, skin prick test, and APT. Of the subjects, 69/75 suffered from atopic dermatitis.

RESULTS

Of 209 oral challenges, 133 were performed with allergen and 76 with placebo. We assessed 77/133 allergen and 2/76 placebo challenges as positive. In 66 of 77 (86%) positive oral challenges, specific IgE in serum to the corresponding allergen was positive; in 64/77 (83%) the skin prick test, and in 42/77 (55%) the APT was positive. While immediate-type reactions were associated with positive skin prick test and proof of specific IgE in serum, late-phase clinical reactions were associated with a positive APT (sensitivity 76%, specificity 95%).

CONCLUSIONS

The APT seems to be a valuable additional tool in the diagnostic work-up of food allergy in children with atopic dermatitis - especially with regard to late-phase clinical reactions. The APT may help to prevent unnecessary restrictive diets which may be the consequence of misjudging late reactions by clinical assessment alone.

Authors+Show Affiliations

Department of Pneumology and Immunology, University Children's Hospital Charité of Humboldt University, Berlin, Germany.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10753020

Citation

Niggemann, B, et al. "The Atopy Patch Test (APT)-- a Useful Tool for the Diagnosis of Food Allergy in Children With Atopic Dermatitis." Allergy, vol. 55, no. 3, 2000, pp. 281-5.
Niggemann B, Reibel S, Wahn U. The atopy patch test (APT)-- a useful tool for the diagnosis of food allergy in children with atopic dermatitis. Allergy. 2000;55(3):281-5.
Niggemann, B., Reibel, S., & Wahn, U. (2000). The atopy patch test (APT)-- a useful tool for the diagnosis of food allergy in children with atopic dermatitis. Allergy, 55(3), pp. 281-5.
Niggemann B, Reibel S, Wahn U. The Atopy Patch Test (APT)-- a Useful Tool for the Diagnosis of Food Allergy in Children With Atopic Dermatitis. Allergy. 2000;55(3):281-5. PubMed PMID: 10753020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The atopy patch test (APT)-- a useful tool for the diagnosis of food allergy in children with atopic dermatitis. AU - Niggemann,B, AU - Reibel,S, AU - Wahn,U, PY - 2001/2/7/pubmed PY - 2001/2/7/medline PY - 2001/2/7/entrez SP - 281 EP - 5 JF - Allergy JO - Allergy VL - 55 IS - 3 N2 - BACKGROUND: While immediate-type clinical reactions to food can quite easily be identified by history or measurement of specific IgE in combination with positive oral food challenges, the evaluation of food allergy in the absence of immediate clinical reactions still presents diagnostic difficulties--particularly in children with atopic dermatitis. The objective of this study was to evaluate the diagnostic value of the atopy patch test (APT) with regard to late-phase reactions observed in double-blind, placebo-controlled food challenges with cow's milk, hen's egg, wheat, and soybean. METHODS: We investigated 75 children (median age 2.1 years) with suspected food allergy by double-blind, placebo-controlled food challenges, specific IgE in serum, skin prick test, and APT. Of the subjects, 69/75 suffered from atopic dermatitis. RESULTS: Of 209 oral challenges, 133 were performed with allergen and 76 with placebo. We assessed 77/133 allergen and 2/76 placebo challenges as positive. In 66 of 77 (86%) positive oral challenges, specific IgE in serum to the corresponding allergen was positive; in 64/77 (83%) the skin prick test, and in 42/77 (55%) the APT was positive. While immediate-type reactions were associated with positive skin prick test and proof of specific IgE in serum, late-phase clinical reactions were associated with a positive APT (sensitivity 76%, specificity 95%). CONCLUSIONS: The APT seems to be a valuable additional tool in the diagnostic work-up of food allergy in children with atopic dermatitis - especially with regard to late-phase clinical reactions. The APT may help to prevent unnecessary restrictive diets which may be the consequence of misjudging late reactions by clinical assessment alone. SN - 0105-4538 UR - https://www.unboundmedicine.com/medline/citation/10753020/The_atopy_patch_test__APT____a_useful_tool_for_the_diagnosis_of_food_allergy_in_children_with_atopic_dermatitis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0105-4538&date=2000&volume=55&issue=3&spage=281 DB - PRIME DP - Unbound Medicine ER -