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Predictive value of peanut skin prick test, specific IgE in peanut-sensitized children in Singapore

Kok Wee Chong1, Seyed Ehsan Saffari2, Nicole Chan3

  • 1Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.

Asia Pacific Allergy
|August 7, 2019
PubMed

Insights

Predictive decision points for peanut allergy diagnosis were established in Singapore. A peanut skin prick test (SPT) wheal size of ≥8 mm and serum IgE of ≥6 kU/L indicate a 95% probability of clinical reaction.

Area of Science:

  • Allergy and Immunology
  • Pediatric Allergy
  • Clinical Diagnostics

Background:

  • Predictive value of peanut skin prick test (SPT) wheal size and serum IgE for peanut allergy has not been established in Singapore.
  • Lack of defined decision points hinders accurate risk stratification for oral food challenges (OFC) in peanut-sensitized children.

Purpose of the Study:

  • To derive clinically useful predictive decision points for peanut allergy.
  • To aid in risk stratification for oral food challenge (OFC) in peanut-sensitized patients.

Main Methods:

  • Retrospective chart review of 269 patients with clinical peanut allergy and 59 tolerating peanuts.
  • Analysis of first peanut SPT wheal size and serum IgE levels at presentation.
  • Inclusion of patients with positive SPT to peanut between 2012-2016.

Main Results:

  • A peanut SPT wheal size of ≥8 mm demonstrated a 95% positive predictive value for clinical reaction.
  • Serum IgE concentration of ≥6 kU/L also provided a 95% positive predictive value for clinical reaction.
  • Larger SPT wheal size correlated with a higher probability of clinical reaction to peanuts.

Conclusions:

  • Derived cutoff values can assist clinicians in assessing OFC risk for peanut-sensitized patients.
  • Further prospective studies are required to validate these diagnostic performance metrics for predicting OFC outcomes.
Abstract

Keywords:
ChildImmunoglobulin EPeanut allergySingaporeSkin prick test

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