Poor utility of the atopy patch test in infants with fresh rectal bleeding

Alves, Flavia Araujo; Cheik, Marina Fernandes Almeida; Nápolis, Ana Carolina Ramos de; Rezende, Érica Rodrigues Mariano de Almeida; Barros, Cristina Palmer; Segundo, Gesmar Rodrigues Silva

doi:10.1016/j.anai.2015.06.005

Cited by 6 publications

(12 citation statements)

References 10 publications

(4 reference statements)

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“…A total of 41 eligible studies were included in our meta‐analysis. Firstly, 578 studies were identified by the initial search and supplemented by 7 additional studies which were searched manually.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies were judged to be high or unclear risk of bias in all domains except the index test. In the patient selection domain: (a) high risk of bias: 25 studies; 9,14,16,18,22,24,25,[27][28][29][30]32,36,[38][39][40][41][42][43][44][45][46][47]49,51 (b) unclear risk of bias: 10 studies; 7,15,17,19,21,23,26,35,37,50 (c) low risk of bias: 6 studies. 13,20,31,33,34,48 In the index test domain: (a) high risk of bias: 2 studies; 39,46 (b) unclear risk of bias: 2 studies; 23,50 (c) low risk of bias: 37 studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…13,20,31,33,34,48 In the index test domain: (a) high risk of bias: 2 studies; 39,46 (b) unclear risk of bias: 2 studies; 23,50 (c) low risk of bias: 37 studies. In the reference standard domain: (a) high risk of bias: 5 studies; 15,17,21,32,34 (b) unclear risk of bias: 20 studies; 7,14,16,19,[22][23][24][25][27][28][29]35,39,41,43,44,[47][48][49][50] However, the applicability concerns were considered to be low concern in most studies, except 6 studies 16,25,27,32,39,46 to be high concern in the patient selection domain, 3 studies 23,39,50 to be unclear in the index test domain, and 2 studies 27,50 to be unclear in the reference standard domain. Detailed information of QUADAS-2 assessment is represented in Table S2.…”

Section: Quality Assessmentmentioning

confidence: 99%

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The diagnostic value of APT for food allergy in children: a systematic review and meta‐analysis

Luo

Zhang

2019

Pediatric Allergy Immunology

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Background The role of atopy patch test (APT) in the diagnosis of food allergy (FA) remains largely controversial. In our meta‐analysis, we aimed to evaluate the accuracy of APT for diagnosing FA in children. Methods Pubmed, Embase and Cochrane Library were searched for studies regarding the diagnostic value of APT for FA in children compared to oral food challenge (double‐blind placebo‐controlled food challenge and/or open food challenge). The last search was conducted on November 11, 2017. Two reviewers independently screened relevant studies and assessed the quality by QUADAS‐2. Meta‐analysis was performed to calculate the pooled sensitivity, specificity, DOR (diagnostic odds ratio), PLR (positive likelihood ratio), NLR (negative likelihood ratio) with their 95% confidence intervals (CIs). Subgroup analyses were conducted according to different food allergens, atopic dermatitis, gastrointestinal symptoms, and age younger than 3 years. Results Forty‐one studies were included in the meta‐analysis. The pooled sensitivity, specificity, PLR, NLR and DOR were 50.30% (95% CI 48.40%‐52.30%), 86.60% (95% CI 85.30%‐87.80%), 3.405 (95% CI 2.594‐4.470), 0.545 (95% CI 0.469‐0.634) and 7.528 (95% CI 5.507‐11.206), respectively. However, for children with FA‐related gastrointestinal symptoms, the pooled sensitivity and specificity were 57.40% (95% CI 52.10%‐62.50%) and 91.50% (95% CI 88.30%‐94.10%) respectively. Conclusions Our findings suggest that APT is specific but not sensitive for diagnosing FA in children, especially in children with FA‐related gastrointestinal symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

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The diagnostic value of APT for food allergy in children: a systematic review and meta‐analysis

Luo

Zhang

2019

Pediatric Allergy Immunology

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“…A AA apresenta dois mecanismos distintos: 1 2,10,11 . Em crianças amamentadas exclusivamente ao leite materno, o TPO foi realizado apenas com o retorno da proteína do leite na dieta materna 2,10,11 .…”

Section: Introductionunclassified

“…Após um período mínimo de três meses de exclusão, os pacientes realizaram o APT para a proteína do leite de vaca, utilizando leite de vaca in natura, 2 gramas de leite de vaca em pó preparados com 2 ml de solução salina a 0,9%, e 2 gramas de leite de vaca em pó diluídos em 2 gramas de petrolato [10][11][12] . As preparações foram fixadas a câmaras plásticas de 8 Nesta pesquisa nós estamos buscando avaliar o uso Teste Cutâneo de Leitura Tardia ou Patch Test (teste realizado colocando um adesivo nas costas do paciente por 48 horas) no diagnóstico de proctocolite (presença de sangue nas fezes).…”

Section: Introductionunclassified

Acurácia do teste cutâneo de leitura tardia na alergia à proteína do leite de vaca com manifestações gastrointestinais

Gonzaga¹

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Primeiramente agradeço a Deus, por mais uma oportunidade de aprender e por ter me conduzido para que este sonho se tornasse realidade, pois não foi fácil ter chegado até aqui, se eu consegui foi graças a Ele. Ao meu orientador Gesmar, por ter acreditado em mim até o fim, me dado essa oportunidade, pois sem ele não poderia concluir este trabalho, agradeço pela atenção, paciência e apoio científico em todas as etapas, minha eterna gratidão. Ao meu esposo Eduardo, pela paciência e compreensão que foram fundamentais para a conclusão deste sonho. Aos meus pais Flávio e Cristina, pelo exemplo de superação, dedicação, carinho, apoio e incentivo que foram fundamentais em todos os momentos da minha vida, e que juntos não mediram esforços para me ajudar, cuidando do Arthur e da Eduarda na minha ausência. Ao meu irmão, Thauan e minha cunhada Gabriela pelo apoio e compreensão. À minha cunhada Mariana e meus sogros Nina e Jair pelo apoio e compreensão. À minha tia Carmen pelo exemplo de alegria e amor à vida, dispondo de seu tempo para cuidar dos meus pequenos ao longo deste estudo. À Marina, pela amizade e carinho, mas, acima de tudo, pela dedicação e presteza com que realizou todos os exames e acompanhou todo o estudo. À Dra. Érica e a Dra. Cristina, pela ajuda na triagem das crianças, pela competência em dividir os conhecimentos e pelas palavras de incentivo a não desistir. À Flávia e Luciana Carneiro pela amizade, apoio e ajuda durante todo esse tempo de convivência. À Ana Paula, Ismara, Cinara e Tayane pelo apoio e pelas palavras de força e incentivo que fizeram a diferença nessa etapa final. À Daniela Nogueira e Renata Paniago pela ajuda, apoio e compreensão. Às secretarias da pós-graduação, Gisele e Viviane, pela atenção e dedicação em auxiliar os alunos. Aos profissionais que trabalham no lactário do Hospital de Clínicas da Universidade Federal de Uberlândia, pela presteza com que pesavam os alimentos utilizados nos exames. A todos os pacientes e seus familiares, pela valiosíssima participação, dispondo de seu tempo para contribuir com esta pesquisa. Enfim, a todos que, direta ou indiretamente, contribuíram para que este sonho se realizasse. Muito obrigada!!! "Tudo posso naquele que me fortalece" Filipenses 4:13 RESUMO Introdução: Alergia alimentar é uma reação adversa ao alimento que ocorre após sua ingestão com envolvimento de mecanismos imunológicos. As manifestações clínicas do tipo não (imunoglobulina E) IgE mediada, são caracterizadas pelo aparecimento tardio dos sintomas. Objetivo: avaliar a acurácia do teste cutâneo de leitura tardia, também conhecido por atopy patch test para a predição de tolerância oral após o tratamento com dieta de exclusão em pacientes com diagnóstico de alergia à proteína do leite de vaca não IgE mediada e sintomas gastrointestinais. Método: Estudo transversal com participação de 32 pacientes com diagnóstico de alergia à proteína do leite de vaca não IgE mediado com manifestações gastrointestinais. Após período mínimo de 90 dias de dieta de exclusão, os pacientes realizaram o teste cutâ...

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The role of the atopy patch test in the diagnostic work-up of non-IgE gastrointestinal food allergy in children: a systematic review

et al. 2023

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The “Atopy Patch Test” (APT) has been proposed as a diagnostic tool for food allergies (FA), especially in children with FA-related gastrointestinal symptoms. However, its diagnostic accuracy is debated, and its usefulness is controversial. The aim of this systematic review was to evaluate the APT diagnostic accuracy compared with the diagnostic gold standard, i.e., the oral food challenge (OFC), in children affected by non-IgE mediated gastrointestinal food allergies, including the evaluation in milk allergic subgroup. Both classical non-IgE mediated clinical pictures and food induced motility disorders (FPIMD) were considered. The search was conducted in PubMed and Scopus from January 2000 to June 2022 by two independent researchers. The patient, intervention, comparators, outcome, and study design approach (PICOS) format was used for developing key questions, to address the APT diagnostic accuracy compared with the oral food challenge (OFC). The quality of the studies was assessed by the QUADAS-2 system. The meta‐analysis was performed to calculate the pooled sensitivity, specificity, DOR (diagnostic odds ratio), PLR (positive likelihood ratio), and NLR (negative likelihood ratio) with their 95% confidence intervals (CI). Out of the 457 citations initially identified via the search (196 on PubMed and 261 on Scopus), 37 advanced to full-text screening, and 16 studies were identified to be included in the systematic review. Reference lists from relevant retrievals were searched, and one additional article was added. Finally, 17 studies were included in the systematic review. The analysis showed that APT has a high specificity of 94% (95%CI: 0.88–0.97) in the group of patients affected by FPIMD. Data showed a high pooled specificity of 96% (95% CI: 0.89–0.98) and the highest accuracy of APT in patients affected by cow’s milk allergy (AUC = 0.93). Conclusion: APT is effective in identifying causative food in children with food-induced motility disorders. What is Known:• Atopy patch test could be a useful diagnostic test for diagnosing food allergy, especially in children with food allergy-related gastrointestinal symptoms. What is New:• Atopy patch test may be a useful tool in diagnosing non IgE food allergy, especially in children with food-induced gastrointestinal motility disorders and cow's milk allergy.

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Poor utility of the atopy patch test in infants with fresh rectal bleeding

Cited by 6 publications

References 10 publications

The diagnostic value of APT for food allergy in children: a systematic review and meta‐analysis

The diagnostic value of APT for food allergy in children: a systematic review and meta‐analysis

Acurácia do teste cutâneo de leitura tardia na alergia à proteína do leite de vaca com manifestações gastrointestinais

The role of the atopy patch test in the diagnostic work-up of non-IgE gastrointestinal food allergy in children: a systematic review

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