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Correlation of serum allergy (IgE) tests performed by different assay systems.

https://arctichealth.org/en/permalink/ahliterature86170
Source
J Allergy Clin Immunol. 2008 May;121(5):1219-24
Publication Type
Article
Date
May-2008
Author
Wang Julie
Godbold James H
Sampson Hugh A
Author Affiliation
Department of Pediatrics, Division of Allergy and Immunology, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. Julie.wang@mssm.edu
Source
J Allergy Clin Immunol. 2008 May;121(5):1219-24
Date
May-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child, Preschool
Humans
Hypersensitivity - blood - diagnosis
Immunoassay - methods
Immunoglobulin E - blood
Reproducibility of Results
Sensitivity and specificity
Abstract
BACKGROUND: In vitro testing is commonly used to diagnose and manage allergies. Clinical reactivity has been correlated with food-specific IgE levels by using the ImmunoCAP (Phadia, Uppsala, Sweden). OBJECTIVE: To determine whether IgE levels derived from different assays are equivalent to those measured by ImmunoCAP. METHODS: Fifty patients from the Mount Sinai Pediatric Allergy practice were prospectively enrolled. For each deidentified sample, specific IgE levels were measured to egg, milk, peanut, cat, birch, and Dermatophagoides farinae at different laboratories, each using a different assay system (Phadia ImmunoCAP, Agilent Turbo-MP, and Siemens Immulite 2000). Results were analyzed to determine whether IgE measurements were equivalent. Food allergen-specific IgE levels were correlated with clinical data and around empirically determined thresholds that predict probability of clinical disease in 50% or 95% of subjects. RESULTS: Variable degrees of agreement existed among the 3 assays. Immulite 2000 overestimated all specific IgE levels compared with ImmunoCAP. Turbo-MP overestimated for egg but underestimated for birch and D farinae. Differences for milk, peanut, and cat were observed, without a trend toward overestimation or underestimation. Furthermore, several values for the food allergens were discrepant around the 50% and 95% positive predictive values for clinical reactivity. CONCLUSION: Discrepancies in specific IgE values from 3 different assays can potentially lead to altered management and treatment. The predictive values for clinical reactivity associated with food-specific IgE levels determined by ImmunoCAP should not be applied to results from other assays.
PubMed ID
18243289 View in PubMed
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The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy.

https://arctichealth.org/en/permalink/ahliterature85637
Source
J Allergy Clin Immunol. 2008 Jul;122(1):145-51
Publication Type
Article
Date
Jul-2008
Author
Maloney Jennifer M
Rudengren Magnus
Ahlstedt Staffan
Bock S A
Sampson Hugh A
Author Affiliation
Mount Sinai School of Medicine, New York, NY, USA. jennifer.maloney@mssm.edu
Source
J Allergy Clin Immunol. 2008 Jul;122(1):145-51
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Allergens - immunology
Child
Child, Preschool
Double-Blind Method
Female
Food Hypersensitivity - diagnosis - immunology
Humans
Immunoglobulin E - blood
Infant
Male
Nuts - immunology
Peanut Hypersensitivity - diagnosis
Questionnaires
Seeds - immunology
Abstract
BACKGROUND: The gold standard for diagnosing food allergy is the double-blind, placebo-controlled food challenge. Diagnostic food-specific IgE levels might assist in diagnosing food allergies and circumventing the need for food challenges. OBJECTIVES: The purpose of this study was to determine the utility of food-specific IgE measurements for identifying symptomatic peanut, tree nut, and seed allergies and to augment what is known about the relationships among these foods. METHODS: Patients referred for suspected peanut or tree nut allergies answered a questionnaire about their perceived food allergies. Allergen-specific diagnoses were based on questionnaire, medical history, and, when relevant, skin prick tests and serum specific IgE levels. Sera from the patients were analyzed for specific IgE antibodies to peanuts, tree nuts, and seeds by using ImmunoCAP Specific IgE (Phadia, Inc, Uppsala, Sweden). RESULTS: Three hundred twenty-four patients (61% male; median age, 6.1 years; range, 0.2-40.2 years) were evaluated. The patients were highly atopic (57% with atopic dermatitis and 58% with asthma). The majority of patients with peanut allergy were sensitized to tree nuts (86%), and 34% had documented clinical allergy. The relationship between diagnosis and allergen-specific IgE levels were estimated by using logistic regression. Diagnostic decision points are suggested for peanut and walnut. Probability curves were drawn for peanut, sesame, and several tree nuts. High correlations were found between cashew and pistachio and between pecan and walnut. CONCLUSIONS: Quantification of food-specific IgE is a valuable tool that will aid in the diagnosis of symptomatic food allergy and might decrease the need for double-blind, placebo-controlled food challenges.
PubMed ID
18502490 View in PubMed
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