Predictive values of component‐specific IgE for the outcome of peanut and hazelnut food challenges in children. Issue 1 (30th November 2014)

• Record Type: Journal Article
• Authors: Beyer, K.; Grabenhenrich, L.; Härtl, M.; Beder, A.; Kalb, B.; Ziegert, M.; Finger, A.; Harandi, N.; Schlags, R.; Gappa, M.; Puzzo, L.; Röblitz, H.; Millner‐Uhlemann, M.; Büsing, S.; Ott, H.; Lange, L.; Niggemann, B.
• Is Part Of: Allergy. Volume 70:Issue 1(2015:Jan.)
• Page Start: 90
• Page End: 98
• Publication Date: 2014-11-30
• Subjects: Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.12530
• Languages: English
• ISSNs: 0105-4538

Abstract

<abstract abstract-type="main" id="all12530-abs-0001"> <title>Abstract</title> <sec id="all12530-sec-0001" sec-type="section"> <title>Background</title> <p>Oral challenges are the gold standard in food allergy diagnostic, but time‐consuming. Aim of the study was to investigate the role of peanut‐ and hazelnut‐component‐specific IgE in the diagnostics of peanut and hazelnut allergy and to identify cutoff levels to make some challenges superfluous.</p> </sec> <sec id="all12530-sec-0002" sec-type="section"> <title>Methods</title> <p>In a prospective and multicenter study, children with suspected peanut or hazelnut allergy underwent oral challenges. Specific IgE to peanut, hazelnut, and their components (Ara h 1, Ara h 2, Ara h 3, and Ara h 8, Cor a 1, Cor a 8, Cor a 9, and Cor a 14) were determined by ImmunoCAP‐FEIA.</p> </sec> <sec id="all12530-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 210 children were challenged orally with peanut and 143 with hazelnut. 43% of the patients had a positive peanut and 31% a positive hazelnut challenge. With an area under the curve of 0.92 and 0.89, respectively, Ara h 2 and Cor a 14‐specific IgE discriminated between allergic and tolerant children better than peanut‐ or hazelnut‐specific IgE. For the first time, probability curves for peanut and hazelnut components have been calculated. A 90% probability for a positive peanut or hazelnut challenge was estimated for Ara h 2‐specific IgE at 14.4 kU/l and for Cor a 14‐specific IgE at 47.8 kU/l. A 95% probability could only be estimated for Ara h 2 at 42.2 kU/l.</p> </sec> <sec id="all12530-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Ara h 2‐ and Cor a 14‐specific IgE are useful to estimate the probability for a positive challenge outcome in the diagnostic work‐up of peanut or hazelnut allergy making some food challenges superfluous.</p> </sec> </abstract>