Background

In children younger than 2 years, studies evaluating the value of skin prick tests (SPTs) and specific immunoglobulin E (sIgE) results to predict persistence or resolution of egg allergy (EA) are limited. In addition, the value of egg yolk (EY) sIgE and fresh egg (FE) SPTs has not been well characterized.

Objective

To investigate the optimal decision points (ODPs) for outgrowing allergy with SPTs and sIgE tests for egg allergen preparations.

Methods

SPTs for FE, egg white (EW), and EY, sIgE tests for EW and EY, and oral food challenges (OFCs) were performed in children with suspected EA. Reactive patients strictly avoided all dietary egg. After 1 year, EA was reevaluated with addition OFCs, SPTs, and sIgE tests.

Results

A total of 81 children (median age, 7 months; age range, 2-24 months) were enrolled. Notably, 4 children with a history of anaphylaxis and 60 of 77 children with a positive challenge result underwent egg elimination. The 1-year follow-up OFC test was performed on 59 children. A total of 27 reacted to egg. No persistent patient had a follow-up SPT result for FE of 4 mm or less (positive predictive values of 100% and negative predictive value of 56% for outgrowth). The diameters of the initial SPT for FE decreased 50% or more in half of the patients who outgrew EA. The ODPs for outgrowing allergy for follow-up sIgE tests for EY and EW were 2.1 kU/L or less (positive predictive value of 86.2%) and 4.0 kU/L or less (positive predictive value of 84.6%), respectively.

Conclusion

A SPT diameter for FE of 4 mm or less and sIgE values of 2.1 kU/L or less for EY and 4.0 kU/L or less for EW have a good positive predictive value for outgrowth of EA in children younger than 2 years.

中文翻译：

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新鲜鸡蛋皮刺试验和蛋黄特异性免疫球蛋白E的功效。

背景

在2岁以下的儿童中，评估皮肤点刺试验（SPTs）和特定免疫球蛋白E（sIgE）结果的价值以预测鸡蛋过敏（EA）持续或消退的研究有限。此外，蛋黄（EY）sIgE和新鲜鸡蛋（FE）SPT的价值尚未很好地表征。

目的

用鸡蛋过敏原制剂的SPT和sIgE测试来调查过敏反应超出最佳的最佳决策点（ODP）。

方法

对怀疑患有EA的儿童进行了FE，蛋清（EW）和EY的SPT，EW和EY的sIgE测试以及口服食物攻击（OFC）。反应性患者严格避免所有饮食鸡蛋。1年后，通过添加OFC，SPT和sIgE测试对EA进行了重新评估。

结果

共有81名儿童（中位年龄7个月；年龄范围2-24个月）入组。值得注意的是，有4例有过敏反应史的儿童和77例具有积极挑战结果的儿童中有60例进行了卵消除。对59名儿童进行了为期1年的随访OFC测试。共有27人对鸡蛋起了反应。没有持续患者对FE的随访SPT结果为4 mm或更小（阳性预测值为100％，阴性预测值为56％）。FE的初始SPT直径在超过EA的一半患者中减少了50％或更多。EY和EW的sIgE随访检测对过敏反应超出的ODP分别为2.1 kU / L或以下（阳性预测值为86.2％）和4.0 kU / L或以下（阳性预测值为84.6％）。

结论

FE的SPT直径为4 mm或更小，EY的sIgE值为2.1 kU / L或更小，EW的sIgE值为4.0 kU / L或更小，对于2岁以下儿童的EA的生长具有良好的积极预测价值。