Pilot study: Assessing the clinical diagnosis of allergy in atopic children using a microarray assay in addition to skin prick testing and serum specific IgE

被引:12
作者
Foong R.-X. [1 ,2 ]
Roberts G. [3 ]
Fox A.T. [1 ]
Toit G. [1 ]
机构
[1] Guy's and St. Thomas' NHS Foundation Trust, Division of Asthma, Allergy and Lung Biology, London
[2] University College of London, Institute of Child Health, London
[3] Southampton and David Hide Centre, University of Southampton, National Institute for Health Research Respiratory Biomedical Research Unit, Southampton
关键词
Aeroallergens; Atopic dermatitis; Diagnostic investigations; Food allergy;
D O I
10.1186/s12948-016-0046-z
中图分类号
学科分类号
摘要
Background: Children with atopic dermatitis (AD) are at risk of developing allergy. Alongside clinical history, testing modalities include skin prick tests (SPT), specific immunoglobulin-E (sp-IgE) and recently, microarray assays. The aim of this pilot study was to assess current tests and the ISAC sIgE-112 system in the diagnosis of food and aeroallergen allergy. Methods: Children aged 0-11 years with moderate to severe AD were included. An initial allergy assessment including clinical history, SPT and sp-IgE was performed to determine food and aeroallergen sensitization. A second independent clinical assessment using the same information given to the first assessor and ISAC test results for food and aeroallergen sensitization was also made for each participant. The results from both were compared. Results: 30 children [mean age 3.91 years (SD 3.3)] were included; 53.3 and 46.7 % had moderate and severe AD, respectively. Sp-IgE tests had a higher percentage of positive results compared to SPT and ISAC tests for common allergens. There was a significant difference between the three tests in detecting aeroallergen sensitization (p = 0.038), especially between sp-IgE and ISAC tests, but no significant difference between the tests for food allergen sensitization. There was good agreement between the two assessors; 70 % of the children had a change in diagnosis, with 60 % having at least one diagnosis added and 40 % having at least one diagnosis removed. Conclusions: There is a role for the use of ISAC testing in diagnosing sensitization and allergy in children with AD as it leads to a change in diagnosis for many patients. Further work is required to assess its clinical and cost effectiveness. © 2016 The Author(s).
引用
收藏
相关论文
共 22 条
[1]  
Bruin Weller M.S., Knulst A.C., Meijer Y., Bruijnzeel-Koomen C.A., Pasmans S.G., Evaluation of the child with atopic dermatitis, Clin Exp Allergy, 42, 3, pp. 352-362, (2012)
[2]  
Weidinger S.N.N., Atopic dermatitis (Seminar), Lancet., 387, pp. 1109-1122, (2015)
[3]  
Alduraywish S.A., Lodge C.J., Vicendese D., Lowe A.J., Erbas B., Matheson M.C., Et al., Sensitization to milk, egg and peanut from birth to 18 years: a longitudinal study of a cohort at risk of allergic disease, Pediatr Allergy Immunol, 27, pp. 83-91, (2015)
[4]  
Gustafsson D., Sjoberg O., Foucard T., Development of allergies and asthma in infants and young children with atopic dermatitis-a prospective follow-up to 7 years of age, Allergy, 55, 3, pp. 240-245, (2000)
[5]  
Wolkerstorfer A., Wahn U., Kjellman N.I., Diepgen T.L., Longueville M., Oranje A.P., Natural course of sensitization to cow's milk and hen's egg in childhood atopic dermatitis: ETAC study group, Clin Exp Allergy, 32, 1, pp. 70-73, (2002)
[6]  
Kumar R., Caruso D.M., Arguelles L., Kim J.S., Schroeder A., Rowland B., Et al., Early life eczema, food introduction, and risk of food allergy in children, Pediatr Allergy Immunol Pulmonol, 23, 3, pp. 175-182, (2010)
[7]  
Benedictis F.M., Franceschini F., Hill D., Naspitz C., Simons F.E., Wahn U., Et al., The allergic sensitization in infants with atopic eczema from different countries, Allergy, 64, 2, pp. 295-303, (2009)
[8]  
Muraro A., Werfel T., Hoffmann-Sommergruber K., Roberts G., Beyer K., Bindslev-Jensen C., Et al., EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy, Allergy, 69, 8, pp. 1008-1025, (2014)
[9]  
Phadia: allergy and autoimmunity-product catalog, (2013)
[10]  
Boyce J.A., Assa'ad A., Burks A.W., Jones S.M., Sampson H.A., Wood R.A., Et al., Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report, Nutr Res, 31, 1, pp. 61-75, (2011)