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Published on: April 21, 2019
Reproducibility of food atopy patch tests over time in the general child population
Milos Jesenak1, Peter Banovcin, Zuzana Rennerova
1Department of Pediatrics, 2nd School of Medicine, University of La Sapienza, Rome, Italy. jesenak@gmail.com
Insights
The atopy patch test (APT) shows poor reproducibility for food allergens in children over time. Further development of stable APT testing substances is urgently needed for accurate allergy diagnosis.
Area of Science:
- Pediatric Allergy and Immunology
- Diagnostic Testing
Background:
- The atopy patch test (APT) is a diagnostic tool for aeroallergen- and food-triggered disorders.
- Technical aspects of APT require further investigation, particularly its reproducibility.
Purpose of the Study:
- To assess the reproducibility of the atopy patch test (APT) for food allergens over time in a general child population.
Main Methods:
- 118 children underwent duplicate APTs with four food allergens.
- Tests were repeated at 7, 14, and 21-day intervals to evaluate reproducibility.
Main Results:
- Very poor reproducibility of APTs was observed in all tested subgroups.
- Reproducibility did not improve regardless of the test site or interval.
- No correlation was found between APT results, skin prick tests, or previous food reactions.
Conclusions:
- Food APTs demonstrate poor and unsatisfactory reproducibility over time.
- There is a critical need for improved, stable, and high-quality APT testing substances.
Background:
The atopy patch test (APT) is no longer an experimental method; it is increasingly being used as a standard diagnostic tool for the characterization of patients with aeroallergen- and food-triggered disorders. Some technical aspects of this test still remain to be answered. We aimed to study the reproducibility of this test over time in the general child population.
Methods:
In a general population of 118 children, we investigated the reproducibility of duplicate APTs with four food allergens in their native form, which were repeated at set intervals from the first test: 7 days (group 1), 14 days (group 2), and 21 days (group 3).
Results:
We observed very poor reproducibility on both sides of the back in all three studied subgroups. The reproducibility rates and Cohen's kappa values did not improve when we did not consider the side of the back. There were no differences in the prevalence of atopy between the subjects with reproducible and nonreproducible APT results. All three groups studied showed no difference in the prevalence rates of atopy. There was no relationship between APT and skin prick test positivity for the same allergen. Questionnaire-derived data about previous food-related reactions did not help in the evaluation of the doubtful nonreproducible APT results with food allergens.
Conclusions:
Our results show that the reproducibility of food APTs is poor and unsatisfactory over time, and there is an urgent need for the development of optimal, stable, and good-quality APT testing substances.
