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The atopy patch test in the diagnostic workup of suspected food-related symptoms in children

Anne Mehl1, Claudia Rolinck-Werninghaus, Ute Staden

  • 1Department of Pediatric Pneumology and Immunology, University Children's Hospital Charité, Berlin, Germany.

The Journal of Allergy and Clinical Immunology
|October 13, 2006
PubMed

Insights

Atopy patch tests (APTs) show good specificity for diagnosing food allergy but do not eliminate the need for oral food challenges in most children. Combining APTs with other tests offers limited improvement in avoiding these challenges.

Area of Science:

  • Allergy and Immunology
  • Pediatric Allergy Diagnostics

Background:

  • Growing need for non-invasive diagnostic tools in food allergy.
  • Oral food challenges (OFCs) are the gold standard but can be burdensome.

Purpose of the Study:

  • To evaluate the diagnostic utility of atopy patch tests (APTs) for food allergy.
  • To determine if APTs can reduce the need for OFCs.

Main Methods:

  • Studied 437 children with suspected food allergy.
  • Performed specific serum IgE (sIgE), skin prick tests (SPTs), APTs, and OFCs.
  • Analyzed 873 OFCs for common allergens like milk, egg, wheat, and soy.

Main Results:

  • APTs demonstrated superior specificity as a standalone test compared to sIgE or SPTs.
  • Combining APTs with SPT or sIgE improved both sensitivity and specificity.
  • Oral food challenges could be avoided in only 0.5%–14% of children even with combined testing.

Conclusions:

  • APTs improve predictive capacity when combined with sIgE or SPTs, but rarely make OFCs superfluous.
  • APTs are time-consuming and require experienced evaluators.
  • In clinical practice, APTs offer minimal added predictive value beyond standard SPT and sIgE for suspected food allergy.
Abstract

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