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Cord blood IgE. III. Prediction of IgE high‐response and allergy
Author(s) -
Hansen L. G.,
Høst A.,
Halken S.,
Holmskov A.,
Husby S.,
Lassen L. B.,
Storm K.,
Østerballe O.
Publication year - 1992
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.1992.tb02080.x
Subject(s) - immunoglobulin e , cord blood , atopy , medicine , immunology , allergy , antibody
Screening of total IgE in 2814 cord blood samples was analysed by Phadebas IgE PRIST in 2 1‐year birth cohorts (1983–1984 and 1985–1986) in Denmark ( n = 1189 + 1625). For follow‐up we chose all infants with cord blood IgE≥0.5 kU/1 and a randomly chosen group of the same size with cord blood IgE < 0.5 kU/1. A total group of 762 infants were clinically evaluated at 18 months of age, and in 688 of these we evaluated total and specific IgE. A diagnosis of definite atopy, probable atopy or no atopy was established. In the present study we defined allergic disease as atopic disease combined with elevated total IgE. We found a statistically significant correlation between cord blood IgE and IgE at 18 months of age. Significantly more infants with elevated cord blood IgE had developed allergic disease at 18 months. A cut‐off value of 0.3 kU/1 for cord blood IgE was superior to the originally suggested 0.5 kU/1. Significantly more infants with elevated cord blood IgE had developed specific IgE antibodies at 18 months. The most frequent specific IgE antibody was towards cow's milk. Specific IgE antibodies were very rarely found when total IgE was not elevated. A total IgE at the age of 18 months > 26 kU/1 could be regarded as elevated. With regard to allergic disease the positive predictive values of cord blood lgE≥0.3 kU/1 in the 2 series were 21 % and the corresponding sensitivities 67% and 46%, respectively. The risk of developing allergic disease was elevated with a factor 3 to 4 when cord blood IgE ≥ 0.3 kU/1. In a high‐risk group based on atopic predisposition and elevated eord blood IgE ≥0.5 kU/1 the relative risk of allergic disease was 5, the predictive value of positive test 38%, the sensitivity 24% and the specificity 96%. Clinical aspectsCord blood IgE was a good predictor of allergic disease at the age of 18 months. A cord blood cut‐off IgE value of 0.3 kU/l was superior to other cord blood IgE values with the Phadebas IgE PRIST method.