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Survey of prick test, total and specific age during food allergy in children
N Kalach1, P Soulaines, A S Imad
1Department of Pediatrics-Neonatology, Pediatric Gastroenterology et Nutrition Unit, Hôpital Cochin-Saint Vincent de Paul, 82, avenue Denfert Rochereau, 75674 Paris, France.
Insights
Pediatric food allergy testing reveals varying results by age and symptoms. Egg white and peanut allergies are common, with specific IgE levels often exceeding skin test positivity.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Diagnostics
- Immunology
Background:
- Food allergies are a growing concern in pediatric populations.
- Accurate diagnostic methods are crucial for managing allergic conditions in children.
Purpose of the Study:
- To systematically analyze biological test results in symptomatic children evaluated for potential food allergies.
- To correlate diagnostic findings with patient demographics and clinical presentations.
Main Methods:
- A cohort of 406 children (2 months to 16 years) underwent cutaneous allergy testing and measurement of total and specific immunoglobulin E (IgE).
- Specific IgE was assessed using RAST Fx5, and children presented with symptoms including eczema, digestive issues, and respiratory problems.
Main Results:
- Overall cutaneous test positivity was 34.1%, with egg white (52%) and peanut (46%) being the most frequent allergens. Positivity decreased with age for egg white.
- Specific IgE positivity was highest for egg white (74%) and peanut (64%), often showing higher titers than skin test results.
- Skin test positivity for egg and peanut was more prevalent in children with eczema compared to those with digestive issues.
Conclusions:
- Diagnostic test results for food allergies in children vary significantly based on age, specific food allergen, and presenting symptoms.
- The study highlights the importance of considering age-related differences and symptom profiles when interpreting allergy test results.
- Specific IgE levels and cutaneous tests provide complementary information in diagnosing pediatric food allergies.
Aim:
To analyze the results of a systematic survey of biological tests in a symptomatic pediatric population consulting for the exploration of a possible food allergy.
Patients And Methods:
406 children included in this study, mean age 3.3+3.2 years (2 months-16 years), 159 girls and 247 boys, had cutaneous tests (Stallergènes, Paris, France), assaying of total and specific IgE, and RAST Fx5 (Pharmacia & Upjohn Diagnostics AB, Uppsala, Sweden). Those children suffering from eczema (34.9%), digestive disorders (26.1%), ORL and pulmonary (8.3%), anaphylactic choc (3.4%) or mixed symptoms (27.3%).
Results:
The overall positivity of cutaneous tests, all confused age periods, was 34.1% with the following order: egg white (52%, p < 0.05 vs. other food), peanut (46%), egg yolk (42%), fish (34%), wheat (33%), soy (32%), cow's milk (24%) and rice (17%). It decreased significantly with age only for the egg white, 61% (0-1 year) and 68% (1-2 years) vs 31% (> 6 years), p < 0.05. The positivity of cutaneous tests for egg and peanut was more frequent with eczema than with digestive manifestations (64% vs. 44%, 57.6% vs. 34% and 56% vs. 38.7%, p < 0.05). The title of total IgE increased with age, r 0.5 p 0.001. The positivity of specific food IgE was more frequent at 4-6 years (68%) than at 0-1 year (36%), p < 0.05. It revealed, all confused age periods, the following order: egg white (74%) and peanut (64%), p < 0.05 vs. other food, cow's milk (59%), wheat (55%), soy (45%) and fish (24%). The number of high specific food IgE titers was significantly higher than the number of positive cutaneous tests by order of frequency; egg white, peanut, cow's milk, wheat and soy, p < 0.05; the reverse was observed for fish, p < 0.05. Percentage of subjects combining a high title of specific food IgE and a positive cutaneous test for egg white (39.4%) was significantly higher than the percentage of those combining a high RAST Fx5 title and a positive cutaneous test for at least one of 6 corresponding foods (25.2%), p < 0.05.
Conclusion:
The positivity of different food cutaneous tests, the rate of total and specific IgE titers and the agreement of the results varied according to age, food and symptoms.
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