Utility of the ratio of food‐specific IgE/total IgE in predicting symptomatic food allergy in children
- 21 June 2005
- Vol. 60 (8), 1034-1039
- https://doi.org/10.1111/j.1398-9995.2005.00806.x
Abstract
Double-blind, placebo-controlled food challenges are time-consuming, expensive and not without risk to patients. Therefore, an in vitro test that could accurately diagnose food allergy would be of great value. To evaluate the utility of the ratio of specific immunoglobulin E (IgE)/total IgE compared with specific IgE (sIgE) alone in predicting symptomatic food allergy. We retrospectively analysed 992 controlled oral food challenges performed in 501 children (median age 13 months). The ratio of sIgE/total IgE was calculated and tested for correlation with the outcome of food challenges. Receiver operator characteristics (ROC)-curves were performed; predicted probabilities and predictive decision points were calculated. A significant correlation was found between the ratio and the outcome of food challenges for cow's milk (CM), hen's egg (HE), and wheat, but not for soy. The ROC and predicted probability curves as well as sensitivity and specificity of the decision points of the ratio were similar to those of sIgE levels for CM, HE and wheat. In view of the greater effort needed to determine the ratio, without benefit compared with the sIgE alone, the calculation of the ratio of sIgE/total IgE for diagnosing symptomatic food allergy offers no advantage for CM, HE, wheat or soy. For the majority of cases controlled oral food challenges still remain the method of choice.Keywords
This publication has 26 references indexed in Scilit:
- Breaking frontiers for better early allergy diagnosisAllergy, 2004
- The utility of specific immunoglobulin E measurements in primary careAllergy, 2004
- Interpretation of subjective symptoms in double‐blind placebo‐controlled food challenges – interobserver reliabilityAllergy, 2004
- Extraordinarily high serum IgE levels and consequences for atopic phenotypesAnnals of Allergy, Asthma & Immunology, 2003
- Utility of food-specific IgE concentrations in predicting symptomatic food allergyJournal of Allergy and Clinical Immunology, 2001
- Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitisJournal of Allergy and Clinical Immunology, 2001
- Scoring of atopic dermatitis by SCORAD using a training atlas by investigators from different disciplinesPediatric Allergy and Immunology, 1997
- Clinical Validation and Guidelines for the SCORAD Index: Consensus Report of the European Task Force on Atopic DermatitisDermatology, 1997
- Pathogenesis of eczemaClinical and Experimental Allergy, 1990
- Clinical effects of diaper types on the skin of normal infants and infants with atopic dermatitisJournal of the American Academy of Dermatology, 1987