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Diagnostic accuracy of patch test in children with food allergy.
Pediatr Allergy Immunol 2015; 26(5):416-22PA

Abstract

BACKGROUND

The gold standard test for confirming whether a child has clinical hypersensitivity reactions to foods is the oral food challenge. Therefore, there is increasing interest in simpler diagnostic markers of food allergy, especially in children, to avoid oral food challenge. The goal of this study was to assess the diagnostic accuracy of atopy patch test in comparison with oral food challenge.

METHODS

We investigated 243 children (mean age, 51 months) referred for evaluation of suspected egg or cow's milk allergy. Skin prick test and atopy patch test were carried out, and after a 2 weeks elimination diet, oral food challenge was performed.

RESULTS

Two hundred and forty-three children underwent OFC to the suspected food. We found clinically relevant food allergies in 40 (65%) children to egg and in 22 (35%) to cow's milk. The sensitivity of skin prick test for both milk and egg was 92%, specificity 91%, positive predictive value 35%, and negative predictive value of 93%. Sensitivity, specificity, positive predictive value, and negative predictive value of atopy patch test for both milk and egg were 21%, 73%, 20%, and 74%, respectively.

CONCLUSION

Our study suggests that there is insufficient evidence for the routine use of atopy patch test for the evaluation of egg and cow's milk allergy. OFC remains gold standard for the diagnosis of egg and milk allergy even in the presence of high costs in terms of both time and risks during application.

Authors+Show Affiliations

Pediatric Department, Division of Allergy and Clinical Immunology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.Pediatric Department, Department of Clinical and Experimental Medicine, Unit of Allergy and Immunology in Evolutive Age, University of Parma, Parma, Italy.Pediatric Department, Department of Clinical and Experimental Medicine, Unit of Allergy and Immunology in Evolutive Age, University of Parma, Parma, Italy.Pediatric Department, Department of Clinical and Experimental Medicine, Unit of Allergy and Immunology in Evolutive Age, University of Parma, Parma, Italy.Pediatric Department, Department of Clinical and Experimental Medicine, Unit of Allergy and Immunology in Evolutive Age, University of Parma, Parma, Italy.Pediatric Department, Department of Clinical and Experimental Medicine, Unit of Allergy and Immunology in Evolutive Age, University of Parma, Parma, Italy.

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25808316

Citation

Caglayan Sozmen, Sule, et al. "Diagnostic Accuracy of Patch Test in Children With Food Allergy." Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, vol. 26, no. 5, 2015, pp. 416-22.
Caglayan Sozmen S, Povesi Dascola C, Gioia E, et al. Diagnostic accuracy of patch test in children with food allergy. Pediatr Allergy Immunol. 2015;26(5):416-22.
Caglayan Sozmen, S., Povesi Dascola, C., Gioia, E., Mastrorilli, C., Rizzuti, L., & Caffarelli, C. (2015). Diagnostic accuracy of patch test in children with food allergy. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 26(5), pp. 416-22. doi:10.1111/pai.12377.
Caglayan Sozmen S, et al. Diagnostic Accuracy of Patch Test in Children With Food Allergy. Pediatr Allergy Immunol. 2015;26(5):416-22. PubMed PMID: 25808316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of patch test in children with food allergy. AU - Caglayan Sozmen,Sule, AU - Povesi Dascola,Carlotta, AU - Gioia,Edoardo, AU - Mastrorilli,Carla, AU - Rizzuti,Laura, AU - Caffarelli,Carlo, Y1 - 2015/05/11/ PY - 2015/03/18/accepted PY - 2015/3/27/entrez PY - 2015/3/27/pubmed PY - 2016/12/15/medline KW - anaphylaxis KW - atopic eczema KW - atopy patch test KW - child KW - cow's milk allergy KW - egg allergy KW - food allergy KW - gastrointestinal symptoms KW - oral food challenge KW - skin prick test SP - 416 EP - 22 JF - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JO - Pediatr Allergy Immunol VL - 26 IS - 5 N2 - BACKGROUND: The gold standard test for confirming whether a child has clinical hypersensitivity reactions to foods is the oral food challenge. Therefore, there is increasing interest in simpler diagnostic markers of food allergy, especially in children, to avoid oral food challenge. The goal of this study was to assess the diagnostic accuracy of atopy patch test in comparison with oral food challenge. METHODS: We investigated 243 children (mean age, 51 months) referred for evaluation of suspected egg or cow's milk allergy. Skin prick test and atopy patch test were carried out, and after a 2 weeks elimination diet, oral food challenge was performed. RESULTS: Two hundred and forty-three children underwent OFC to the suspected food. We found clinically relevant food allergies in 40 (65%) children to egg and in 22 (35%) to cow's milk. The sensitivity of skin prick test for both milk and egg was 92%, specificity 91%, positive predictive value 35%, and negative predictive value of 93%. Sensitivity, specificity, positive predictive value, and negative predictive value of atopy patch test for both milk and egg were 21%, 73%, 20%, and 74%, respectively. CONCLUSION: Our study suggests that there is insufficient evidence for the routine use of atopy patch test for the evaluation of egg and cow's milk allergy. OFC remains gold standard for the diagnosis of egg and milk allergy even in the presence of high costs in terms of both time and risks during application. SN - 1399-3038 UR - https://www.unboundmedicine.com/medline/citation/25808316/Diagnostic_accuracy_of_patch_test_in_children_with_food_allergy_ L2 - https://doi.org/10.1111/pai.12377 DB - PRIME DP - Unbound Medicine ER -