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Role of atopy patch test for diagnosis of food allergy-related gastrointestinal symptoms in children.
Pediatr Allergy Immunol 2015; 26(8):737-41PA

Abstract

BACKGROUND

Double-blind, placebo-controlled food challenge is the gold standard for diagnosing food allergy. However, it is a time-consuming procedure and requires onsite medical supervision and resuscitating medicines and devices on hand. The objective of this study was to compare the atopy patch test (APT) with the oral food challenge test (OFC) in children with suspected food allergy-related gastrointestinal (GI) symptoms.

METHODS

A prospective self-controlled study enrolled children with a history of suspected food allergy-related GI symptoms. Skin prick test (SPT) and APT using lyophilized and commercial allergen extracts for cow's milk, egg, wheat, soy, and shrimp were evaluated, and OFC was performed.

RESULTS

Thirty-nine patients (25 boys, median age 2.4 yrs) with 76 events of suspected food allergy-related GI symptoms were enrolled. SPT was positive in 11/76 events (14.5%). Sensitivity, specificity, predictive values, and likelihood ratio were calculated related to the food challenge outcome. Of 41 OFC, 30 (73.2%) were positive. APT using lyophilized allergen extracts yielded high sensitivity (80%) and high positive predictive value (85.7%). APT using commercial allergen extracts yielded low sensitivity (30%) but high specificity (90%). The negative predictive value of APT using lyophilized and commercial allergen extracts was 53.8% and 32.2%, respectively. All cases with positive APT using lyophilized allergen extracts together with positive SPT also had positive OFC.

CONCLUSION

In contrast to commercial extracts, APT with lyophilized allergen extracts is reliable, safe, and maybe useful for the diagnosis of suspected food allergy-related GI symptoms in children. OFC is still needed in most of the cases.

Authors+Show Affiliations

Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Pub Type(s)

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

Language

eng

PubMed ID

25817700

Citation

Boonyaviwat, Onsuree, et al. "Role of Atopy Patch Test for Diagnosis of Food Allergy-related Gastrointestinal Symptoms in Children." Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, vol. 26, no. 8, 2015, pp. 737-41.
Boonyaviwat O, Pacharn P, Jirapongsananuruk O, et al. Role of atopy patch test for diagnosis of food allergy-related gastrointestinal symptoms in children. Pediatr Allergy Immunol. 2015;26(8):737-41.
Boonyaviwat, O., Pacharn, P., Jirapongsananuruk, O., Vichyanond, P., & Visitsunthorn, N. (2015). Role of atopy patch test for diagnosis of food allergy-related gastrointestinal symptoms in children. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 26(8), pp. 737-41. doi:10.1111/pai.12382.
Boonyaviwat O, et al. Role of Atopy Patch Test for Diagnosis of Food Allergy-related Gastrointestinal Symptoms in Children. Pediatr Allergy Immunol. 2015;26(8):737-41. PubMed PMID: 25817700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of atopy patch test for diagnosis of food allergy-related gastrointestinal symptoms in children. AU - Boonyaviwat,Onsuree, AU - Pacharn,Punchama, AU - Jirapongsananuruk,Orathai, AU - Vichyanond,Pakit, AU - Visitsunthorn,Nualanong, Y1 - 2015/06/05/ PY - 2015/03/24/accepted PY - 2015/3/31/entrez PY - 2015/3/31/pubmed PY - 2016/10/1/medline KW - atopy patch test KW - commercial allergen extract KW - food allergy KW - food challenge test KW - gastrointestinal symptoms KW - lyophilized allergen extract KW - skin prick test SP - 737 EP - 41 JF - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JO - Pediatr Allergy Immunol VL - 26 IS - 8 N2 - BACKGROUND: Double-blind, placebo-controlled food challenge is the gold standard for diagnosing food allergy. However, it is a time-consuming procedure and requires onsite medical supervision and resuscitating medicines and devices on hand. The objective of this study was to compare the atopy patch test (APT) with the oral food challenge test (OFC) in children with suspected food allergy-related gastrointestinal (GI) symptoms. METHODS: A prospective self-controlled study enrolled children with a history of suspected food allergy-related GI symptoms. Skin prick test (SPT) and APT using lyophilized and commercial allergen extracts for cow's milk, egg, wheat, soy, and shrimp were evaluated, and OFC was performed. RESULTS: Thirty-nine patients (25 boys, median age 2.4 yrs) with 76 events of suspected food allergy-related GI symptoms were enrolled. SPT was positive in 11/76 events (14.5%). Sensitivity, specificity, predictive values, and likelihood ratio were calculated related to the food challenge outcome. Of 41 OFC, 30 (73.2%) were positive. APT using lyophilized allergen extracts yielded high sensitivity (80%) and high positive predictive value (85.7%). APT using commercial allergen extracts yielded low sensitivity (30%) but high specificity (90%). The negative predictive value of APT using lyophilized and commercial allergen extracts was 53.8% and 32.2%, respectively. All cases with positive APT using lyophilized allergen extracts together with positive SPT also had positive OFC. CONCLUSION: In contrast to commercial extracts, APT with lyophilized allergen extracts is reliable, safe, and maybe useful for the diagnosis of suspected food allergy-related GI symptoms in children. OFC is still needed in most of the cases. SN - 1399-3038 UR - https://www.unboundmedicine.com/medline/citation/25817700/Role_of_atopy_patch_test_for_diagnosis_of_food_allergy_related_gastrointestinal_symptoms_in_children_ L2 - https://doi.org/10.1111/pai.12382 DB - PRIME DP - Unbound Medicine ER -