Diagnostic Usefulness of the Serum-Specific IgE, the Skin Prick Test and the Atopy Patch Test Compared with That of the Oral Food Challenge Test
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Background: Atopic dermatitis (AD) is frequently associated with food allergies. In addition to the skin prick test (SPT) and serum-specific IgE, the atopy patch test (APT) has been introduced as a diagnostic procedure for food allergies. Objective: Our aim was to evaluate the diagnostic value of the APT, the SPT and the serum-specific IgE levels compared with that of oral food challenge test against milk and egg in AD patients. Methods: We conducted the SPT and APT, and determined the serum-specific IgE levels against milk and egg antigens for 101 patients. Oral food challenge tests were conducted for 86 out of 101 AD patients. The sensitivity,specificity and positive and negative predictable values were calculated for all the tests. Results: Twenty-five patients were positive to oral food challenges. The sensitivity of the APT for milk was 66.7%, while the figures for the SPT and the serum-specific IgE were 35.5% and 14.2%. The sensitivity of the APT for egg was 50%, while that for the SPT and serum-specific IgE were 21.4% and 6.7%. Conclusion: We were able to conclude that the APT test seems to be a valuable additional tool for the diagnostic method of food
Abstract
Background: Atopic dermatitis (AD) is frequently associated with food allergies. In addition to the skin prick test (SPT) and serum-specific IgE, the atopy patch test (APT) has been introduced as a diagnostic procedure for food allergies. Objective: Our aim was to evaluate the diagnostic value of the APT, the SPT and the serum-specific IgE levels compared with that of oral food challenge test against milk and egg in AD patients. Methods: We conducted the SPT and APT, and determined the serum-specific IgE levels against milk and egg antigens for 101 patients. Oral food challenge tests were conducted for 86 out of 101 AD patients. The sensitivity,specificity and positive and negative predictable values were calculated for all the tests. Results: Twenty-five patients were positive to oral food challenges. The sensitivity of the APT for milk was 66.7%, while the figures for the SPT and the serum-specific IgE were 35.5% and 14.2%. The sensitivity of the APT for egg was 50%, while that for the SPT and serum-specific IgE were 21.4% and 6.7%. Conclusion: We were able to conclude that the APT test seems to be a valuable additional tool for the diagnostic method of food
참고문헌 (22)
- Schultz Larsen F, "Epidemiology of atopic dermatitis", Immunol Allergy Clin North Am, 22, pp.1~24 (2002)
- Eichenfield LF, "Consensus conference on pediatric atopic dermatitis", J Am Acad Dermatol, 49, pp.1088~1095 (2003)
- Burks AW, "Atopic dermatitis:clinical relevance of food hypersensitivity reactions", J Pediatr, 113, pp.447~451 (1988)
- Sampson HA, "Food allergy.Part 1:immunopathogenesis and clinical disorders", J Allergy Clin Immunol, 103, pp.717~728 (1999)
- Sicherer SH, "Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management", J Allergy Clin Immunol, 104, pp.S114~S122 (1999)
- Burks AW, "Atopic dermatitis and food hypersensitivity reactions", J Pediatr, 132, pp.132~136 (1998)
- Host A, "A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensitivity reaction", Allergy, 45, pp.587~596 (1990)
- Bock SA, "Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life", Pediatrics, 79, pp.683~688 (1987)
- Niggemann B, "Outcome of double-blind,placebo-controlled food challenge tests in 107 children with atopic dermatitis", Clin Exp Allergy, 29, pp.91~96 (1999)
- Mitchell EB, "Basophils in allergen-induced patch test sites in atopic dermatitis", Lancet, 1, pp.127~130 (1982)
- 장대성, "아토피 피부염 환자에서 음식 항원에 대한 첩포 검사와 특이 IgE치에 관한 연구", 대한피부과학회지, 40(9), pp.1028~1034 (2002), 대한피부과학회
- Leung DYM, "Atopic dermatitis. In: Fitzpatrick’s dermatology in general medicine. 6th ed", pp.1180~1194 (2003), McGraw-Hill
- Hanifin JM, "Diagnostic features of atopic dermatitis", Acta Derm Venereol (Stockh), 92(Suppl), pp.44~47 (1980)
- Severity scoring of atopic dermatitis:the SCORAD index, "Consensus Report of the European Task Force on Atopic Dermatitis", Dermatology, 186, pp.23~31 (1993)
- Bindslev-Jensen C, "Standardization of food challenges in patients with immediate reactions to foods--position paper from the European Academy of Allergology and Clinical Immunology", Allergy, 59, pp.690~697 (2004)
- Roehr CC, "Atopy patch tests,together with determination of specific IgE levels,reduce the need for oral food challenges in children with atopic dermatitis", J Allergy Clin Immunol, 107, pp.548~553 (2001)
- Osterballe M, "The diagnostic accuracy of the atopy patch test in diagnosing hypersensitivity to cow’s milk and hen’s egg in unselected children with and without atopic dermatitis", J Am Acad Dermatol, 51, pp.556~562 (2004)
- Saxon A, "Immediate hypersensitivity: approach to diagnosis. In: Manual of allergy and immunology: diagnosis and therapy. 2nd ed", pp.29~30 (1988), Little-Brown
- Isolauri E, "Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis", J Allergy Clin Immunol, 97, pp.9~15 (1996)
- Yim YS, "A comparative study of atopy patch test using house dust mite antigens with skin prick test and specific serum IgE level in atopic dermatitis", Korean J Dermatol, 39, pp.1072~1079 (2001)
- Rawle FC, "T cell responses to the major allergen from the house dust mite Dermatophagoides pteronyssinus,Antigen P1:comparison of patients with asthma,atopic dermatitis,and perennial rhinitis", J Immunol, 133, pp.195~201 (1984)
- Niggemann B, "Importance of chamber size for the outcome of atopy patch testing in children with atopic dermatitis and food allergy", J Allergy Clin Immunol, 110, pp.515~516 (2002)