An Algorithmic Diagnosis of Children with Suspected Food Allergy in Mediterranean Region and Predictive Values of Food Specific IgE Levels

Sehra Birgül Batmaz
Tuğba Arıkoğlu
Semanur Kuyucu

Abstract

Objective: A food allergy is an abnormal immunological reaction against dietary protein. An increase in the prevalence of food allergy has been reported recently. Although the diagnostic steps such as history, physical examination and laboratory tests are used, the gold standard method for the diagnosis is oral food challenge. The aim of this study is to evaluate the clinical, laboratory findings and test results in children with confirmed food allergy.

Materials and Methods: Th is retrospective study included 234 patients with suspected food allergy who admitted to our Allergy Clinic between January 2009 and August 2011. Food specific IgE, skin prick test and food challenge tests were evaluated. Th e sensitivity, specificity, positive and negative predictive values of food specific IgE levels were calculated for the prediction of food allegy.

Results: One hundred forty seven patients were male and the mean age was 3.7 ± 2.7 years. A total of 356 food provocation tests were performed due to the history of suspected food allergy and/or food specific IgE and skin prick test positivity. A total of 44 oral provocation test results were positive in 32 patients. Cow’s milk allergy (56.8%) was found to be the most frequent identified food allergy followed by egg (29.5%) and nut allergies (9%). Th e performance of food specific IgE levels to distinguish food allergies that were determined by oral provocation tests were calculated by ROC analysis. The statistical cut-off value to predict the cow’s milk allergy was found as ≥ 2.15 kU/l (p< 0.05). The negative predictive value of specific IgE cut-off level for cow’s milk was found as 89.6% in our study.

Coclusion: Although the oral provocation test is considered as the gold standard for the diagnosis, the detection of food specific IgE cut-off levels with good predictive values will strengthen the diagnostic studies.

Keywords

Food allergy, oral, challenge, specifi c IgE
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