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Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root.

Abstract

BACKGROUND

Celery root is a frequent cause of food allergy in pollen-sensitized patients. Because of problems in blinding challenges with fresh vegetables and the risk of anaphylactic reactions, no double-blind, placebo-controlled, food challenges (DBPCFCs) with celery have been published so far.

OBJECTIVE

The aim of the study was to confirm the clinical relevance of celery as a food allergen by DBPCFCs and to evaluate current diagnostic procedures in patients with true allergy.

METHODS

DBPCFCs were performed in 32 patients with a history of an allergic reaction to celery. The patients underwent skin prick tests (SPTs) with celery extracts, crude celery, and different pollen extracts. Specific IgE for celery was determined by using the CAP method.

RESULTS

Twenty-two of 32 patients had a positive DBPCFC result. Two patients reacted to placebo, and 8 patients did not respond to the challenge. Of the nonresponders, 4 reacted to an open provocation with celery. The sensitivity of CAP determination for specific IgE (> or =0.7 kU/L) to celery in patients with a positive DBPCFC result was 73%, 48% to 86% for SPTs (> or =3 mm) with commercial extracts, and 96% for prick-to-prick tests with crude celery. The positive predictive value of the SPT and CAP tests was between 87% and 96%, whereas the specificity and negative predictive values were poor.

CONCLUSION

This study confirms the importance of celery as a food allergen for use in DBPCFCs. The SPT and CAP methods proved to be reliable for the diagnosis of a relevant allergy to celery in regard to sensitivity and positive predictive value but not to specificity and negative predictive value.

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  • Authors+Show Affiliations

    ,

    Allergy Unit, Department of Dermatology, University Hospital, Zürich, Switzerland.

    , , ,

    Source

    MeSH

    Administration, Oral
    Adolescent
    Adult
    Allergens
    Antigens, Plant
    Apiaceae
    Double-Blind Method
    Female
    Food Hypersensitivity
    Humans
    Male
    Middle Aged
    Plant Proteins
    Pollen
    Skin Tests

    Pub Type(s)

    Clinical Trial
    Controlled Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10932083

    Citation

    Ballmer-Weber, B K., et al. "Celery Allergy Confirmed By Double-blind, Placebo-controlled Food Challenge: a Clinical Study in 32 Subjects With a History of Adverse Reactions to Celery Root." The Journal of Allergy and Clinical Immunology, vol. 106, no. 2, 2000, pp. 373-8.
    Ballmer-Weber BK, Vieths S, Lüttkopf D, et al. Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root. J Allergy Clin Immunol. 2000;106(2):373-8.
    Ballmer-Weber, B. K., Vieths, S., Lüttkopf, D., Heuschmann, P., & Wüthrich, B. (2000). Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root. The Journal of Allergy and Clinical Immunology, 106(2), pp. 373-8.
    Ballmer-Weber BK, et al. Celery Allergy Confirmed By Double-blind, Placebo-controlled Food Challenge: a Clinical Study in 32 Subjects With a History of Adverse Reactions to Celery Root. J Allergy Clin Immunol. 2000;106(2):373-8. PubMed PMID: 10932083.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root. AU - Ballmer-Weber,B K, AU - Vieths,S, AU - Lüttkopf,D, AU - Heuschmann,P, AU - Wüthrich,B, PY - 2000/8/10/pubmed PY - 2000/9/19/medline PY - 2000/8/10/entrez SP - 373 EP - 8 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 106 IS - 2 N2 - BACKGROUND: Celery root is a frequent cause of food allergy in pollen-sensitized patients. Because of problems in blinding challenges with fresh vegetables and the risk of anaphylactic reactions, no double-blind, placebo-controlled, food challenges (DBPCFCs) with celery have been published so far. OBJECTIVE: The aim of the study was to confirm the clinical relevance of celery as a food allergen by DBPCFCs and to evaluate current diagnostic procedures in patients with true allergy. METHODS: DBPCFCs were performed in 32 patients with a history of an allergic reaction to celery. The patients underwent skin prick tests (SPTs) with celery extracts, crude celery, and different pollen extracts. Specific IgE for celery was determined by using the CAP method. RESULTS: Twenty-two of 32 patients had a positive DBPCFC result. Two patients reacted to placebo, and 8 patients did not respond to the challenge. Of the nonresponders, 4 reacted to an open provocation with celery. The sensitivity of CAP determination for specific IgE (> or =0.7 kU/L) to celery in patients with a positive DBPCFC result was 73%, 48% to 86% for SPTs (> or =3 mm) with commercial extracts, and 96% for prick-to-prick tests with crude celery. The positive predictive value of the SPT and CAP tests was between 87% and 96%, whereas the specificity and negative predictive values were poor. CONCLUSION: This study confirms the importance of celery as a food allergen for use in DBPCFCs. The SPT and CAP methods proved to be reliable for the diagnosis of a relevant allergy to celery in regard to sensitivity and positive predictive value but not to specificity and negative predictive value. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/10932083/Celery_allergy_confirmed_by_double_blind_placebo_controlled_food_challenge:_a_clinical_study_in_32_subjects_with_a_history_of_adverse_reactions_to_celery_root_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(00)47483-X DB - PRIME DP - Unbound Medicine ER -