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Can family history and cord blood IgE predict sensitization and allergic diseases up to adulthood?
Author(s) -
Nissen Susanne P.,
Kjær Henrik F.,
Høst Arne,
Nielsen Jan,
Halken Susanne
Publication year - 2015
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12264
Subject(s) - medicine , immunoglobulin e , family history , cord blood , immunology , sensitization , cohort , allergy , antibody
Background Long‐term studies of the predictive value of family history and cord blood IgE level until adulthood are few, and their conclusions have been contradictory. Methods Screening of total IgE in 1617 cord blood samples was performed in a Danish birth cohort. All infants with cord blood IgE (CB‐IgE) ≥0.5 kU/l and a corresponding randomly chosen group with CB‐IgE <0.5 kU/l were chosen for follow‐up. Questionnaire‐based interviews, physical examination, specific IgE testing, and from 10 yr also spirometry, were carried out at 1½, 5, 10, 15, and 26 yr. Predefined diagnostic criteria were used. Results A total of 455 infants were included, 188 with CB‐IgE ≥0.5 kU/l and 267 with CB‐IgE <0.5 kU/l. Follow‐up rates were high, 288 (63%) attended the 26‐yr follow‐up. Family history and elevated CB‐IgE were significantly associated to allergic disease until 26 yr. Concerning any allergic symptoms at 1½ yr the positive and negative predictive values (PPV and NPV), the sensitivity and specificity of CB‐IgE ≥0.5 kU/l, was 29%, 81%, 54%, and 61%, respectively. The corresponding figures at 26 yr were 46%, 62%, 43%, and 65%. Overall, family history as well as CB‐IgE ≥0.5 kU/l was associated with high NPV and specificity, but low PPV and sensitivity. Conclusion Although family history and elevated CB ‐IgE were significantly associated with primarily atopic disease until 26 yr, none of these were strong predictors for subsequent sensitization and allergic symptoms from childhood until early adulthood. It appears that the predictive capacity of CB ‐IgE decreases in adolescence and early adulthood.