Guidelines on the clinical usefulness of determination of specific immunoglobulin E to foods.
The diagnostic gold standard for food allergy is challenge with the culprit food, particularly in double-blind placebo-controlled challenge. This approach involves risks and consumes both time and resources. A more efficient system would be desirable. The detection of serum specific immunoglobulin E (sIgE) against the culprit food enables us to establish sensitization, although this is not always accompanied by clinical reactivity. Age, symptoms (immediate/late reaction, local/systemic reaction), concomitant condition (eg, atopic dermatitis, pollinosis) and selection sample criteria (eg, presence of symptoms related to ingestion, positive skin prick test result) can influence the detection and concentration of IgE against foods. We analyze the clinical usefulness of sIgE determination in light of studies in which oral food challenge is used as the diagnostic method. We review clinical usefulness at diagnosis and in the decision to reintroduce the food, as well as the prognostic value of the determination of IgE to foods.
García
B E
BE
Hospital Virgen del Camino, Pamplona, Spain. bgarciaf@cfnavarra.es
Gamboa
P M
PM
Asturias
J A
JA
López-Hoyos
M
M
Sanz
M L
ML
Caballero
M T
MT
García
J M
JM
Labrador
M
M
Lahoz
C
C
Longo Areso
N
N
Martínez Quesada
J
J
Mayorga
L
L
Monteseirín
F J
FJ
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D003937:Diagnosis, Differential; D000939:Epitopes / Q000276:immunology; D005240:Feasibility Studies; D005260:Female; D005502:Food / Q000009:adverse effects; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D015983:Selection Bias; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D013030:Spain
D000485:Allergens; D000939:Epitopes; D007073:Immunoglobulin E