Predictive value of specific IgE for clinical peanut allergy in children: relationship with eczema, asthma, and setting (primary or secondary care)

Clinical and Translational Allergy

Paul LP Brand¹  Graham Roberts⁴  Lambert D Dikkeschei²  Wilma J van Veen³ 

[1] UMCG Postgraduate School of Medicine, University Medical Centre, Groningen, the Netherlands;Clinical Laboratory, Isala hospital, Zwolle, the Netherlands;Princess Amalia Children’s Centre, Isala hospital, PO Box 10400, 8000 GK, Zwolle, the Netherlands;David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK

关键词: Teenagers;    Children;    Asthma;    Eczema;    Peanut sensitization;    Peanut-specific IgE;    Peanut allergy;   

Others  :  794171
DOI  :  10.1186/2045-7022-3-34

 received in 2013-05-26, accepted in 2013-10-01,  发布年份 2013

【 摘 要 】

The usefulness of peanut specific IgE levels for diagnosing peanut allergy has not been studied in primary and secondary care where most cases of suspected peanut allergy are being evaluated. We aimed to determine the relationship between peanut-specific IgE levels and clinical peanut allergy in peanut-sensitized children and how this was influenced by eczema, asthma and clinical setting (primary or secondary care). We enrolled 280 children (0–18 years) who tested positive for peanut-specific IgE (> 0.35 kU/L) requested by primary and secondary physicians. We used predefined criteria to classify participants into three groups: peanut allergy, no peanut allergy, or possible peanut allergy, based on responses to a validated questionnaire, a detailed food history, and results of oral food challenges.

Fifty-two participants (18.6%) were classified as peanut allergy, 190 (67.9%) as no peanut allergy, and 38 (13.6%) as possible peanut allergy. The association between peanut-specific IgE levels and peanut allergy was significant but weak (OR 1.46 for a 10.0 kU/L increase in peanut-specific IgE, 95% CI 1.28-1.67). Eczema was the strongest risk factor for peanut allergy (aOR 3.33, 95% CI 1.07-10.35), adjusted for demographic and clinical characteristics. Asthma was not significantly related to peanut allergy (aOR 1.93, 95% CI 0.90-4.13). Peanut allergy was less likely in primary than in secondary care participants (OR 0.46, 95% CI 0.25-0.86), at all levels of peanut-specific IgE.

The relationship between peanut-specific IgE and peanut allergy in children is weak, is strongly dependent on eczema, and is weaker in primary compared to secondary care. This limits the usefulness of peanut-specific IgE levels in the diagnosis of peanut allergy in children.

【 授权许可】

   
2013 van Veen et al.; licensee BioMed Central Ltd.

【 图 表 】

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