Predictive value of specific IgE for clinical peanut allergy in children: relationship with eczema, asthma, and setting (primary or secondary care)
Predictive value of specific IgE for clinical peanut allergy in children: relationship with eczema, asthma, and setting (primary or secondary care)
The usefulness of peanut specific IgE levels for diagnosing peanut allergy has not been studied in primary and secondary care where most cases of suspected peanut allergy are being evaluated. We aimed to determine the relationship between peanut-specific IgE levels and clinical peanut allergy in peanut-sensitized children and how this was influenced by eczema, asthma and clinical setting (primary or secondary care). We enrolled 280 children (0-18 years) who tested positive for peanut-specific IgE (> 0.35 kU/L) requested by primary and secondary physicians. We used predefined criteria to classify participants into three groups: peanut allergy, no peanut allergy, or possible peanut allergy, based on responses to a validated questionnaire, a detailed food history, and results of oral food challenges.Fifty-two participants (18.6%) were classified as peanut allergy, 190 (67.9%) as no peanut allergy, and 38 (13.6%) as possible peanut allergy. The association between peanut-specific IgE levels and peanut allergy was significant but weak (OR 1.46 for a 10.0 kU/L increase in peanut-specific IgE, 95% CI 1.28-1.67). Eczema was the strongest risk factor for peanut allergy (aOR 3.33, 95% CI 1.07-10.35), adjusted for demographic and clinical characteristics. Asthma was not significantly related to peanut allergy (aOR 1.93, 95% CI 0.90-4.13). Peanut allergy was less likely in primary than in secondary care participants (OR 0.46, 95% CI 0.25-0.86), at all levels of peanut-specific IgE.The relationship between peanut-specific IgE and peanut allergy in children is weak, is strongly dependent on eczema, and is weaker in primary compared to secondary care. This limits the usefulness of peanut-specific IgE levels in the diagnosis of peanut allergy in children.
peanut allergy, peanut-specific ige, peanut sensitization, eczema, asthma, children, teenagers
1-7
van Veen, Wilma J.
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Dikkeschei, Lambert D.
38b99679-a80e-40b8-91eb-7120905befe7
Roberts, Graham
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Brand, Paul L.P.
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10 October 2013
van Veen, Wilma J.
4b662d1c-1bb9-4487-88ba-b94673d62eb3
Dikkeschei, Lambert D.
38b99679-a80e-40b8-91eb-7120905befe7
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Brand, Paul L.P.
9d1a3547-1255-4548-964a-28a95a1440fa
van Veen, Wilma J., Dikkeschei, Lambert D., Roberts, Graham and Brand, Paul L.P.
(2013)
Predictive value of specific IgE for clinical peanut allergy in children: relationship with eczema, asthma, and setting (primary or secondary care).
Clinical and Translational Allergy, 3 (34), .
(doi:10.1186/2045-7022-3-34).
(PMID:24112405)
Abstract
The usefulness of peanut specific IgE levels for diagnosing peanut allergy has not been studied in primary and secondary care where most cases of suspected peanut allergy are being evaluated. We aimed to determine the relationship between peanut-specific IgE levels and clinical peanut allergy in peanut-sensitized children and how this was influenced by eczema, asthma and clinical setting (primary or secondary care). We enrolled 280 children (0-18 years) who tested positive for peanut-specific IgE (> 0.35 kU/L) requested by primary and secondary physicians. We used predefined criteria to classify participants into three groups: peanut allergy, no peanut allergy, or possible peanut allergy, based on responses to a validated questionnaire, a detailed food history, and results of oral food challenges.Fifty-two participants (18.6%) were classified as peanut allergy, 190 (67.9%) as no peanut allergy, and 38 (13.6%) as possible peanut allergy. The association between peanut-specific IgE levels and peanut allergy was significant but weak (OR 1.46 for a 10.0 kU/L increase in peanut-specific IgE, 95% CI 1.28-1.67). Eczema was the strongest risk factor for peanut allergy (aOR 3.33, 95% CI 1.07-10.35), adjusted for demographic and clinical characteristics. Asthma was not significantly related to peanut allergy (aOR 1.93, 95% CI 0.90-4.13). Peanut allergy was less likely in primary than in secondary care participants (OR 0.46, 95% CI 0.25-0.86), at all levels of peanut-specific IgE.The relationship between peanut-specific IgE and peanut allergy in children is weak, is strongly dependent on eczema, and is weaker in primary compared to secondary care. This limits the usefulness of peanut-specific IgE levels in the diagnosis of peanut allergy in children.
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Accepted/In Press date: 1 October 2013
Published date: 10 October 2013
Keywords:
peanut allergy, peanut-specific ige, peanut sensitization, eczema, asthma, children, teenagers
Organisations:
Human Development & Health
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Local EPrints ID: 388698
URI: http://eprints.soton.ac.uk/id/eprint/388698
PURE UUID: 556a8aea-2a39-47b6-b7c7-dec132baa368
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Date deposited: 02 Mar 2016 11:08
Last modified: 15 Mar 2024 03:22
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Author:
Wilma J. van Veen
Author:
Lambert D. Dikkeschei
Author:
Paul L.P. Brand
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