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Diagnostic value of hazelnut allergy tests including rCor a 1 spiking in double-blind challenged children

L J Masthoff1, S G Pasmans, E van Hoffen

  • 1Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, the Netherlands. l.j.n.masthoff@umcutrecht.nl

Allergy
|December 20, 2011
PubMed

Insights

Diagnostic tests for hazelnut allergy in children show good negative predictive value, especially with rCor a 1 spiking. However, positive predictive values remain moderate, with spiking decreasing them. Skin prick tests outperform IgE levels.

Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Diagnostics
  • Food Hypersensitivity Research

Background:

  • The diagnostic accuracy of hazelnut allergy tests in children undergoing double-blind challenges is not well-established.
  • Understanding the performance of current diagnostic methods is crucial for accurate clinical decision-making.

Purpose of the Study:

  • To evaluate the diagnostic performance of specific IgE (sIgE) levels and skin prick tests (SPT) for hazelnut allergy in children.
  • To assess the impact of rCor a 1 spiking on the accuracy of sIgE testing.
  • To correlate diagnostic test results with the severity of hazelnut allergy and history of accidental ingestion.

Main Methods:

  • Analysis of data from 151 children who underwent double-blind placebo-controlled hazelnut food challenges.
  • Determination of positive predictive value (PPV) and negative predictive value (NPV) for hazelnut sIgE and SPT.
  • Evaluation of the effect of rCor a 1 spiking on ImmunoCAP sIgE measurements and analysis of accidental ingestion history.

Main Results:

  • Hazelnut sIgE ≥0.35 kU(A)/l demonstrated moderate predictive value; PPV reached 73% at a cutoff of 26 kU(A)/l.
  • rCor a 1 spiking increased NPV from 91% to 100% but slightly decreased PPV from 41% to 38% for sIgE ≥0.35 kU(A)/l.
  • SPT was a superior predictor of hazelnut allergy and severity compared to sIgE levels; accidental ingestion history had a 59% predictive value.

Conclusions:

  • Current diagnostic tests for pediatric hazelnut allergy exhibit good negative predictive value, enhanced by rCor a 1 spiking.
  • Positive predictive values for these tests are moderate and can be reduced by rCor a 1 spiking.
  • Skin prick testing and a detailed history of accidental ingestion are valuable in diagnosing hazelnut allergy in children.
Abstract

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