title: Diagnostic usefulness of component-resolved diagnosis by skin prick tests and specific IgE to single allergen components in children with allergy to fruits and vegetables.
abstract: BACKGROUND
  The accurate identification of sensitizing proteins in patients allergic to plant-derived foods is extremely important, allowing a correct dietary advice. We aimed to evaluate the diagnostic usefulness of skin prick tests (SPT) and specific IgE (sIgE) with single molecular allergen components in children with allergy to fruits and vegetables.
  
  
  METHODS
  Twenty children underwent SPT with a palm profilin (Pho d 2, 50 μg/mL); a Mal d 1-enriched apple extract (2 μg/mL) (PR-10 allergen); and a peach Lipid Transfer Protein (LTP) (Pru p 3, 30 μg/mL). Detection of sIgE to rBet v 1, rBet v 2, Phl p 12 and Pru p 3 was also measured.
  
  
  RESULTS
  Allergy to multiple fruits and vegetables was observed in 11 (55%) children. Sensitization by SPT to Pho d 2, Mal d 1, and Pru p 3 occurred in 5, 7, and 8 cases, respectively. LTP sensitization appeared to be associated with peach allergy but not with severe reactions, and profilins sensitization to melon and tomato allergy. Kiwi sensitization (12 cases), the plant-derived food that caused more allergic reactions, seemed mostly species-specific. The concordance of SPT extracts and sIgE to the corresponding pan-allergens was high for profilins (k=0.857) and LTP (k=0.706), while for PR-10 allergens it was absent (k=0.079).
  
  
  CONCLUSIONS
  Pan-allergen sensitization in children with allergy to fruits and vegetables was common and often multiple. There was no association of severe reactions to LTP sensitization. The introduction of routine SPT to pan-allergens can be a simple and feasible way of improving diagnostic and therapeutic efficacy.
authors.affiliation: Unidade de Imunoalergologia - Centro Hospitalar do Porto, E.P.E., Porto, Portugal. Electronic address: te_vieira@yahoo.com.br.
authors.forename: T
authors.initials: T
authors.lastname: Vieira
authors.affiliation: Unidade de Imunoalergologia - Centro Hospitalar do Porto, E.P.E., Porto, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Cunha
authors.affiliation: Serviço de Imunologia - Centro Hospitalar do Porto, E.P.E., Porto, Portugal.
authors.forename: E
authors.initials: E
authors.lastname: Neves
authors.affiliation: Unidade de Imunoalergologia - Centro Hospitalar do Porto, E.P.E., Porto, Portugal.
authors.forename: H
authors.initials: H
authors.lastname: Falcão
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D005638:Fruit / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D012882:Skin Tests / Q000379:methods*; D014675:Vegetables / Q000276:immunology*
chemical_list: D000485:Allergens; D007073:Immunoglobulin E