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[Diagnostic capacity of skin prick test in egg and cow's milk allergic infants].
Zhonghua Er Ke Za Zhi 2011; 49(5):329-32ZE

Abstract

OBJECTIVE

Mean diameter is the most common used parameter for wheal response assessment after skin prick test. This study aimed to investigate the diagnostic capacity of mean diameter according to the outcome of oral food challenge, and to determine the cut-off points that could render food challenges unnecessary.

METHOD

Data of 173 children referred to the Division of Primary Child Health Care for the evaluation of suspected food allergy were prospectively studied. All children underwent skin prick test and open food challenge to the relevant food(s) in clinic. The mean wheal diameter of skin prick test was measured, and open food challenge was performed to confirm food allergy. The SPSS software package version 13.0 for windows (SPSS, Chicago, IL, USA) was used for all statistical analysis. Open food challenge was taken as the gold standard for diagnosis. Diagnostic capacity of skin prick test, including the sensitivity, specificity, positive predictive value, negative predictive value, was calculated by cross-table. In addition, receiver operating characteristic curve (ROC) was plotted and area under the curve (AUC) was calculated to quantify the accuracy of the parameter.

RESULT

For the 173 children, 271 open food challenges were performed with egg white, egg yolk and cow's milk, In which 123 were positive, 99 children were diagnosed as food allergy. Cutaneous symptoms (87.0%) were most common, followed by gastrointestinal symptoms (9.8%). The AUC of mean diameter was 0.794 for egg white, 0.804 for egg yolk and 0.904 for cow's milk. The sensitivity of skin prick test with a cut-off value of ≥ 3 mm was ranged from 71% to 87%, while the specificity was between 31% and 57%. The authors also defined food specific skin prick test mean diameters that were 100% diagnostic for allergy to egg white (≥ 8.5 mm), egg yolk (≥ 5.5 mm), cow's milk (≥ 5.5 mm).

CONCLUSION

Predictive decision points for a positive outcome of food challenges can be calculated for egg and cow's milk using mean diameter. It may help to simplify the diagnostic procedure of food allergy.

Authors+Show Affiliations

Division of Primary Child Health Care, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

21624281

Citation

Yan, Jun-mei, et al. "[Diagnostic Capacity of Skin Prick Test in Egg and Cow's Milk Allergic Infants]." Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics, vol. 49, no. 5, 2011, pp. 329-32.
Yan JM, Chen J, Li HQ, et al. [Diagnostic capacity of skin prick test in egg and cow's milk allergic infants]. Zhonghua Er Ke Za Zhi. 2011;49(5):329-32.
Yan, J. M., Chen, J., Li, H. Q., & Hu, Y. (2011). [Diagnostic capacity of skin prick test in egg and cow's milk allergic infants]. Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics, 49(5), pp. 329-32.
Yan JM, et al. [Diagnostic Capacity of Skin Prick Test in Egg and Cow's Milk Allergic Infants]. Zhonghua Er Ke Za Zhi. 2011;49(5):329-32. PubMed PMID: 21624281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnostic capacity of skin prick test in egg and cow's milk allergic infants]. AU - Yan,Jun-mei, AU - Chen,Jing, AU - Li,Hai-qi, AU - Hu,Yan, PY - 2011/6/1/entrez PY - 2011/6/1/pubmed PY - 2012/3/30/medline SP - 329 EP - 32 JF - Zhonghua er ke za zhi = Chinese journal of pediatrics JO - Zhonghua Er Ke Za Zhi VL - 49 IS - 5 N2 - OBJECTIVE: Mean diameter is the most common used parameter for wheal response assessment after skin prick test. This study aimed to investigate the diagnostic capacity of mean diameter according to the outcome of oral food challenge, and to determine the cut-off points that could render food challenges unnecessary. METHOD: Data of 173 children referred to the Division of Primary Child Health Care for the evaluation of suspected food allergy were prospectively studied. All children underwent skin prick test and open food challenge to the relevant food(s) in clinic. The mean wheal diameter of skin prick test was measured, and open food challenge was performed to confirm food allergy. The SPSS software package version 13.0 for windows (SPSS, Chicago, IL, USA) was used for all statistical analysis. Open food challenge was taken as the gold standard for diagnosis. Diagnostic capacity of skin prick test, including the sensitivity, specificity, positive predictive value, negative predictive value, was calculated by cross-table. In addition, receiver operating characteristic curve (ROC) was plotted and area under the curve (AUC) was calculated to quantify the accuracy of the parameter. RESULT: For the 173 children, 271 open food challenges were performed with egg white, egg yolk and cow's milk, In which 123 were positive, 99 children were diagnosed as food allergy. Cutaneous symptoms (87.0%) were most common, followed by gastrointestinal symptoms (9.8%). The AUC of mean diameter was 0.794 for egg white, 0.804 for egg yolk and 0.904 for cow's milk. The sensitivity of skin prick test with a cut-off value of ≥ 3 mm was ranged from 71% to 87%, while the specificity was between 31% and 57%. The authors also defined food specific skin prick test mean diameters that were 100% diagnostic for allergy to egg white (≥ 8.5 mm), egg yolk (≥ 5.5 mm), cow's milk (≥ 5.5 mm). CONCLUSION: Predictive decision points for a positive outcome of food challenges can be calculated for egg and cow's milk using mean diameter. It may help to simplify the diagnostic procedure of food allergy. SN - 0578-1310 UR - https://www.unboundmedicine.com/medline/citation/21624281/[Diagnostic_capacity_of_skin_prick_test_in_egg_and_cow's_milk_allergic_infants]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0578-1310&year=2011&vol=49&issue=5&fpage=329 DB - PRIME DP - Unbound Medicine ER -