Evaluation of the predictive value of total IgE and absolute eosinophil levels on allergy test positivity (original) (raw)
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Background We have prospectively studied 220 children attending our Division because they suffered from atopic dermatitis (AD), asthma, and allergic rhinitis (AR) to assess the epidemiology of atopic diseases, and effectiveness of the diagnostic tests commonly used in allergic children. Patients and Methods Among the 220 children there were 142 males (64.5%) and 78 females (35.5%) aged as follows: 57 (25.9%) 0-2 year old, 48 (21.8%) 2-4 year old, 49 (22.3%) 4-6 year old, 66 (30%) >6 year old. The diagnosis included family and personal history, physical examination, skin prick tests (SPT) and total and specific IgE (sIgE) levels. We tested inhalant and food allergens. Results There were 101 asthmatic, 88 with AD, and 31 children with AR. The analysis of variance confirmed the age influence of PRIST with a high significance (p= 0.0001). SPTs were prevalent in all groups for Der p, but casein only in one group, and Lolium perenne only in two groups. RAST showed a higher uniformity, that is CM (cow’s milk) and egg for one group, Der p and Lolium perenne for the remaining groups several correlations among diagnostic tests and the age of children were evaluated with the analysis of variance. Conclusion We emphasize that atopic diseases are genetically transmitted, that AD develops at a younger age than asthma (p= 0.0052), and that SPTs have a greater effectiveness for inhalant allergens, positive at all age levels; in food allergy (FA) SPTs are less adequate and feasible
Allergy, 2011
Background: Early identification of children at risk for later development of allergic disease is essential for early intervention and initiation of proper treatment and management. Objective: To investigate the relationship between low levels (0.1-0.7 kU A /l) of IgE sensitization to food and inhalant allergens and symptoms of eczema, rhinitis, and asthma from birth to 5 years of age. Methods: Children (268) were followed prospectively from birth to 5 years of age with physical examinations and measurements of s-IgE at 6, 12, 24, and 60 months of age. Results: Seventy-four percent of the children with low levels of s-IgE to egg and/or milk at the age of 6 months were still sensitized to one or more allergens at age 2 years. Eighty-four percent of the children with low levels of s-IgE to any of the studied allergens at 12 months of age were still sensitized at age 5. The low levels of egg and milk s-IgE also significantly increased the risk for eczema at the same age and also increased the risk for eczema at 2 years of age. Conclusion: Low levels of s-IgE can be detected from the age of 6 months and are related to further IgE sensitization. The low levels seem to be of importance for both the association to present symptoms and for prediction of future allergic symptoms, especially eczema during early infancy. A detectable s-IgE level, albeit low, could be a clear signal that the immune system is alerted and should be followed.
Total IgE and Absolute Eosinophils Count as a Predictor of Allergic Diseases in Children
Egyptian Journal of …
Objective: To study the role of both serum total IgE levels and the absolute eosinophils count, total IgE alone, absolute eosinophils count alone as a marker of allergy in children, and to see their association with the host factors (age and sex) Methods: A retrospective study was conducted at King Abdul Aziz University Hospital-Jeddah (KAUH), during the year 2008. Three hundred children below the age of fifteen years meeting the inclusion criteria were enrolled for the study. Serum total IgE levels and absolute eosinophils count were done in all patients. Data was collected and tabulated. Chi-square was applied to test the association of the variables using SPSS and p-value of <0.05 was taken as statistically significant. Results: Out of 300 patients, 27(9%) had raised both serum total IgE and absolute eosinophils count, 146(48.67%) had raised serum total IgE alone, 40(13.3%) had raised absolute eosinophils count alone. Both IgE plus absolute eosinophilic count, total IgE alone and absolute eosinophilic count alone are not significantly related to the child sex with (P-values 0.759, 0.742, 0.699) respectively, however all are related significantly to the child age (P-values <0.004, <0.001, <0.012) respectively. All are not related significantly to systemic allergies except the significant relation between the absolute eosinophils count with atopic dermatitis (Pvalue <0.031) Conclusion: Serum total IgE level and absolute eosinophils count, total IgE alone and absolute eosinophils count alone are not a good predictor of allergy in children except that the absolute eosinophils count can be considered as a strong predictor of atopic dermatitis in children. It's clear now, that as the child age increase the positivity of all the tests increase also. CORE Metadata, citation and similar papers at core.ac.uk
Clinical & Experimental Allergy, 2000
Background The combination of genetic susceptibility and environmental factors induce allergic sensitization and subsequently local in¯ammation, resulting in atopic manifestations. Objective To examine whether immunological features re¯ecting sensitization (total and speci®c IgE levels, allergen-induced proliferative responses and skin tests) and markers of in¯ammation (plasma sE-selectin and blood eosinophils) are related to the clinical expression of atopy and whether they precede atopic disease in children up to 2 years of age. Methods The development of these markers during the ®rst 2 years of life was studied prospectively in 133 newborns at high risk to develop atopic disease. Results The prevalence of atopic disease increased from 25% at 12 months to 32% at 24 months of age. The children with food allergy at 12 months, who all had atopic dermatitis (AD), turned out to have asthma-like disease in 40% and AD in 100% at the age of 24 months. Total IgE levels increased with time and from 12 months onward levels started to differ markedly between atopics and nonatopics. Food-speci®c IgE antibodies were signi®cantly associated with AD (relative risk [RR] 2.39), food (RR 1.32) and upperairway allergy (RR 1.20), and house dust mite-speci®c IgE antibodies with upper-airway allergy (RR 5.00). A positive skin test was signi®cantly associated with AD (RR 2.90) and food allergy (RR 1.36). The in¯ammation markers investigated, were not related to the clinical expression or preceded atopic disease at 2 years of age in high-risk children. Conclusion Positive skin tests and speci®c IgE to food or inhalant allergens were related to the clinical expression of different atopic diseases. The combination of AD and food allergy at 12 months re¯ected the strongest risk factor in this high risk cohort for the development of asthma-like disease at 24 months of age.
Quantitative IgE antibody assays in allergic diseases
Journal of Allergy and Clinical Immunology, 2000
During the past several years, immunoassays for specific IgE antibodies have been refined to permit reporting results in mass units. Thus quantitative immunoassays for IgE antibodies may be an adjunct to skin tests. In cases of food allergy among children with atopic dermatitis, cutoff values for IgE antibody concentrations to egg, milk, peanut, and fish have been derived to provide 95% positive and 90% negative predictive values. Food-specific IgE antibody determinations can also be used to predict which food allergies are resolving spontaneously. Elevated egg-specific IgE antibody levels in infancy are associated with significantly increased risk for development of inhalant allergies later in childhood. In cases of inhalant allergy, specific IgE antibody levels correlate closely with results of inhalation challenge studies in cat-sensitive persons. Also, mite-specific IgE antibody levels correlate significantly with the mite allergen contents of reservoir dust in the homes of mite-sensitive persons. Immunoassays for quantitation of specific IgE antibodies may be used to document aller-gen sensitization over time and to evaluate the risk of reaction on allergen exposure. However, immunoassays and skin tests are not entirely interchangeable, and neither will replace the other in appropriate circumstances. (J Allergy Clin Immunol 2000;105:1077-84.)
The predictive value of allergen skin prick tests and IgE tests at pre-school age: The PACT study
Pediatric Allergy and Immunology, 2014
Background: Sensitization toward allergens, as determined by skin prick test (SPT) or specific IgE (sIgE), is a predictor for the later presence of allergy-related disease (atopic eczema, allergic rhinoconjuctivitis and asthma). However, it is not known whether SPT or sIgE should be the preferred test. The aim of this study was to compare the predictive ability of SPT and sIgE when performed in a general population of 2-yr-old children. Methods: In a prospective, longitudinal population-based study of children aged 2-6 yr, SPT and sIgE for nine common allergens were performed at 2 yr. Allergyrelated disease was evaluated by clinical examination and questionnaire at 2 and 6 yr of age (n = 199). Results: Skin prick test or sIgE was positive in 10.6% and 21.1% in the 2-yr-old children, respectively. The prevalence of allergy-related disease was 25.6% at 2 yr and 25.1% at 6 yr. Half of the cases at 2 yr were transient. Both SPT and sIgE were statistically significant predictors for later allergy-related disease, OR = 6.5 (95% CI 2.3-18.6) and OR = 4.1 (95% CI 1.9-9.0), respectively. Receiver operating characteristic analysis showed that SPT and sIgE had comparable predictive ability for atopic eczema, asthma or any allergy-related disease, but sIgE had better ability to predict later allergic rhinoconjunctivitis. Conclusion: Sensitization at 2 yr may be useful predictors of allergy-related disease later in childhood. The predictive ability of SPT and sIgE were mainly comparable; however, it may be that sIgE is the preferred choice in young children when the aim is to predict allergic rhinoconjunctivitis.
International Archives of Allergy and Immunology, 2007
specificity for atopy were assessed on the other 50% of nonatopic and on all atopic subjects. The 95th percentile of IgEt reference values in non-smokers was 148 kU/l in women and 169 kU/l in men, while it was 194 and 220 kU/l in female and male smokers, respectively: serum IgE-t above the 95th percentile identifies ! 32% and above the 99th percentile ! 20% of atopic adults (low sensitivity), but a serum IgE-t below the 95th percentile identifies 1 90% and below the 99th percentile identifies 1 95% of non-atopic adults (good specificity). Due to the adequate specificity, IgE-t values exceeding the normal limits confirm a suspected atopic status; however, because of the low sensitivity, values below the cutoff seem not to exclude an atopic status with sufficient accuracy.