Outcome of double‐blind, placebo‐controlled food challenge tests in 107 children with atopic dermatitis

Niggemann,; Sielaff,; Beyer,; Binder,; Wahn,

doi:10.1046/j.1365-2222.1999.00454.x

Cited by 237 publications

(148 citation statements)

References 24 publications

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“…9,10 Removal of the allergenic food from the diet can lead to resolution of AD in selected cases. 9 However, formation of new eczematous lesions after a food challenge is uncommon, 9,11 and parental suspicions of food allergy have been shown to decrease when skin symptoms are controlled with proper medication. 12,13 The sensitization pattern of IgE is influenced by maternal and environmental factors during the first year of life, which may contribute to the development of food allergies.…”

Section: What This Study Addsmentioning

confidence: 99%

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

et al. 2015

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BACKGROUND AND OBJECTIVES: Children with atopic dermatitis (AD) have a higher risk for development of food allergies. The objective of this study was to examine incidence of food allergy development in infants with AD and the predictive value of food-antigen-specific immunoglobulin E measurements.METHODS: This trial examined the long-term safety and efficacy of pimecrolimus cream 1% in .1000 infants (3-18 months) with mild-to-severe AD without a history of food allergy. Food allergy development was followed throughout a 36-month randomized double-blind phase followed by an open-label (OL) phase up to 33 months. Additionally, sIgE for cow's milk, egg white, peanut, wheat, seafood mix, and soybean was measured by ImmunoCAP at baseline, end of the double-blind phase, and end of OL phase.RESULTS: By the end of the OL phase, 15.9% of infants with AD developed at least 1 food allergy; allergy to peanut was most common (6.6%), followed by cow's milk (4.3%) and egg white (3.9%). Seafood, soybean, and wheat allergies were rare. Levels of sIgE for milk, egg, and peanut increased with severity of AD, as determined by Investigator's Global Assessment score. We assigned sIgE decision points for the 6 foods and tested their ability to predict definite food allergy in this population. Positive predictive values for published and newly developed sIgE decision points were low (,0.6 for all values tested). CONCLUSIONS:In a large cohort of infants at risk for development of food allergy, sIgE levels were not clinically useful for predicting food allergy development. WHAT'S KNOWN ON THIS SUBJECT:Food allergies are often thought to be a common trigger in atopic dermatitis (AD). Serum immunoglobulin E is frequently used to assess food sensitization and clinical allergy, but few studies have assessed it longitudinally in infants and children with AD. WHAT THIS STUDY ADDS:In a large infant population with mild to moderate AD, 15.9% of patients developed food allergy during the study. Serum immunoglobulin E decision points had low positive predictive values, indicating that they are of limited use in this population.

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Section: What This Study Addsmentioning

confidence: 99%

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

et al. 2015

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“…As a method for assessing food antigens, the double-blind, placebo-controlled food challenge (DBPCFC) is known to be the most informative method to date 9 . However, there are many difficulties for conducting a DBPCFC on the food allergies of AD patients.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Usefulness of the Serum-Specific IgE, the Skin Prick Test and the Atopy Patch Test Compared with That of the Oral Food Challenge Test

et al. 2010

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Background: Atopic dermatitis (AD) is frequently associated with food allergies. In addition to the skin prick test (SPT) and serum-specific IgE, the atopy patch test (APT) has been introduced as a diagnostic procedure for food allergies. Objective: Our aim was to evaluate the diagnostic value of the APT, the SPT and the serum-specific IgE levels compared with that of oral food challenge test against milk and egg in AD patients. Methods: We conducted the SPT and APT, and determined the serum-specific IgE levels against milk and egg antigens for 101 patients. Oral food challenge tests were conducted for 86 out of 101 AD patients. The sensitivity, specificity and positive and negative predictable values were calculated for all the tests. Results: Twenty-five patients were positive to oral food challenges. The sensitivity of the APT for milk was 66.7%, while the figures for the SPT and the serum-specific IgE were 35.5% and 14.2%. The sensitivity of the APT for egg was 50%, while that for the SPT and serum-specific IgE were 21.4% and 6.7%. Conclusion: We were able to conclude that the APT test seems to be a valuable additional tool for the diagnostic method of food allergies in AD. (Ann Dermatol 22(4) 404∼411, 2010)

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“…Cuando el paciente presentaba varias reacciones a alimentos repetidas en corto espacio de tiempo se desarrollaba el eczema, sugiriendo que la ingestión repetida de alimentos y el rascado estarían contribuyendo al desarrollo de la dermatitis. Hallazgos similares han sido comunicados por otros autores 8 .…”

Section: Papel De Los Alergenos En La Dermatitis Atópicaunclassified

Test epicutáneos con inhalantes en el estudio de la dermatitis atópica

Echechipía

Gómez

Lasa

et al. 2003

Anales Sis San Navarra

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RESUMENEn un 80% de pacientes con dermatitis atópica se demuestra la presencia de IgE específica frente a alergenos alimentarios o ambientales. También se ha demostrado la exacerbación de las lesiones de la dermatitis tras ingestión o inhalación de alergenos y su mejoría al reducir la exposición alergénica en un subgrupo de pacientes con dermatitis atópica. Aunque el prick y la determinación de IgE específica en suero son técnicas muy sensibles, las pruebas epicutáneas aplicando el alergeno directamente en la piel podrían ser el método diagnóstico ideal ya que reproducen la respuesta inflamatoria característica de la enfermedad en el propio órgano de choque que es la piel. Sin embargo, existe gran variabilidad en los resultados obtenidos mediante pruebas epicutáneas con aeroalergenos, debido fundamentalmente a diferencias metodológi-cas, que se revisan en este trabajo. Por último, presentamos los resultados de realizar pruebas epicutáneas con alergenos inhalantes a nuestros pacientes con dermatitis atópica y controles, obteniendo un 27% de parches positivos, fundamentalmente con ácaros y en aquellos pacientes con dermatitis más grave sin que exista una completa concordancia con la técnica del prick. Por ello, las pruebas epicutáneas parecen un método de diagnóstico alergológico que puede ser útil y complementario a las técnicas de rutina como el prick o la determinación de IgE específica en suero, pero queda pendiente su adecuada estandarización.Palabras clave. Dermatitis atópica. Pruebas epicutáneas. Alergenos. ABSTRACTIn some 80% of patients with atopic dermatitis, the presence of specific IgE is found when facing food or environmental allergens. It has also been demonstrated in a sub-group of patients with atopic dermatitis that the dermatitis lesions are exacerbated following the ingestion or inhalation of allergens, and that they improve with reduction of exposure to allergens. Although the prick method and the determination of specific IgE in serum are highly sensitive techniques, epicutaneous tests, applying the allergen directly to the skin, might be the ideal diagnostic method since they reproduce the characteristic inflammatory response of the disease on the affected organ itself, the skin. However, there is great variability in the results obtained through epicutaneous tests with aeroallergens, basically due to methodological differences, which are reviewed in this paper. Finally, we present the results of carrying out epicutaneous tests with inhalant allergens on our patients with atopic dermatitis and controls, where some 27% of positive patches were obtained, basically with acari, and in those patients with more severe dermatitis, without there being complete concordance with the prick technique. For this reason, the epicutaneous test appears to be a method of allergological diagnosis that might be useful and complementary to the routine techniques of the prick method and the determination of specific IgE in serum, but it is in need of suitable standardization.

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Outcome of double‐blind, placebo‐controlled food challenge tests in 107 children with atopic dermatitis

Cited by 237 publications

References 24 publications

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements

Diagnostic Usefulness of the Serum-Specific IgE, the Skin Prick Test and the Atopy Patch Test Compared with That of the Oral Food Challenge Test

Test epicutáneos con inhalantes en el estudio de la dermatitis atópica

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