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IgE testing can predict food allergy status in patients with moderate to severe atopic dermatitis
NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
Leidos Biomed Res Inc, Clin Res Directorate, Clin Monitoring Res Program, NCI Campus, Frederick, MD USA.
Leidos Biomed Res Inc, Clin Res Directorate, Clin Monitoring Res Program, NCI Campus, Frederick, MD USA.
NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
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2019 (English)In: Annals of Allergy, Asthma & Immunology, ISSN 1081-1206, E-ISSN 1534-4436, Vol. 122, no 4, p. 393-400Article in journal (Refereed) Published
Abstract [en]

Background: Diagnosing food allergy in patients with atopic dermatitis (AD) is complicated by their high rate of asymptomatic sensitization to foods, which can lead to misdiagnosis and unnecessary food avoidance.

Objective: We sought to determine whether food-specific (sIgE) or component immunoglobulin (Ig) E levels could predict allergic status in patients with moderate to severe AD and elevated total IgE.

Methods: Seventy-eight children (median age, 10.7 years) with moderate to severe AD were assessed for a history of clinical reactivity to milk, egg, peanut, wheat, and soy. The IgE levels for each food and its components were determined by ImmunoCAP. The level and pattern of IgE reactivity to each food and its components, and their ratio to total IgE, were compared between subjects who were allergic and tolerant to each food.

Results: Ninety-one percent of subjects were sensitized, and 51% reported allergic reactivity to at least 1 of the 5 most common food allergens. Allergy to milk, egg, and peanut were most common, and IgE levels to each of these foods were significantly higher in the allergic group. Component IgEs most associated with milk, egg, and peanut allergy were Bos d8, Gal d1, and Ara h2, respectively. The ratio of sIgE to total IgE offered no advantage to sIgE alone in predicting allergy.

Conclusion: Specific IgE levels and the pattern of IgE reactivity to food components can distinguish AD subjects allergic vs tolerant to the major food allergens and may therefore be helpful in guiding the clinical management of these patients. 

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2019. Vol. 122, no 4, p. 393-400
National Category
Respiratory Medicine and Allergy Immunology in the medical area
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URN: urn:nbn:se:uu:diva-382516DOI: 10.1016/j.anai.2019.01.001ISI: 000463164500009PubMedID: 30639434OAI: oai:DiVA.org:uu-382516DiVA, id: diva2:1307997
Available from: 2019-04-30 Created: 2019-04-30 Last updated: 2019-04-30Bibliographically approved

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