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Specificity of allergen skin testing in predicting positive open food challenges to milk, egg and peanut in children
Author(s) -
Sporik R.,
Hill D. J.,
Hosking C. S.
Publication year - 2000
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1046/j.1365-2222.2000.00928.x
Subject(s) - medicine , food allergy , oral food challenge , allergen , peanut allergy , egg white , population , milk allergy , egg allergy , food allergens , allergy , pediatrics , food science , environmental health , immunology , biology
Background The specificity of allergen skin prick testing to diagnose clinically relevant food allergy is controversial. Objectives To determine the specificity of the allergen weal diameter to correctly identify children who react on formal open food challenges. Methods Over a 9‐year period children referred to a tertiary allergy clinic for the evaluation of suspected food allergy were prospectively studied. Allergen skin prick testing to cow milk, egg white and peanut extracts (Dome‐Hollister‐Stier, Spokane, WA, USA) was undertaken using a lancet technique. All children underwent open food challenges to the relevant food(s) in a hospital clinic. Challenges were classified as positive, if objective signs were seen; negative, if the child could tolerate normal quantities of the food, daily, for one week; or inconclusive if none of the former criteria were met. Results Five hundred and fifty‐five challenges were undertaken in 467 children: 339 challenges to cow milk, 121 to egg, and 95 to peanut. Fifty‐five percentage of challenges were positive, 37% negative, and 8% inconclusive. For each food it was possible to identify a skin weal diameter at, and above, which negative reactions did not occur: cow milk, 8 mm; egg, 7 mm; peanut, 8 mm. In contrast, positive reactions could occur with a skin wheal diameter of 0 mm. Conclusions In this high risk referral population it was possible to define skin weal diameters to egg, milk and peanut above which open oral food challenges were positive (100% specificity). By utilizing these measurements the need for formal food challenges can be reduced.