title: Discordance between aeroallergen specific serum IgE and skin testing in children younger than 4 years.
abstract: BACKGROUND
  Atopic sensitization to aeroallergens in early life has been found to be a strong risk factor for the development of persisting asthma in young children with recurrent wheeze.
  
  
  OBJECTIVE
  To assess the yield of skin prick test (SPT) compared with allergen specific serum IgE (sIgE) testing at identifying aeroallergen sensitization in atopic children younger than 4 years.
  
  
  METHODS
  Concordance between SPT and allergen-specific sIgE testing for 7 common aeroallergens was analyzed in 40 atopic inner-city children 18 to 48 months of age (mean [SD], 36 [9] months) with recurrent wheezing and family history of asthma and/or eczema.
  
  
  RESULTS
  In 80% of children one or more allergen sensitizations would have been missed if only SPT had been performed, and in 38% of children one or more sensitizations would have been missed if only sIgE testing had been performed. Agreement between the SPT and sIgE test was fair for most allergens (κ = -0.04 to 0.50), as was correlation between sIgE levels and SPT grade (ρ = 0.21 to 0.55). Children with high total sIgE (≥300 kU/L) were more likely to have positive sIgE test results, with negative corresponding SPT results (P = .02).
  
  
  CONCLUSIONS
  Our study revealed a significant discordance between allergen-specific SPT and sIgE testing results for common aeroallergens, suggesting that both SPT and sIgE testing should be performed when diagnosing allergic sensitization in young children at high risk of asthma.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01028560.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY 10461, USA. gabriele.de-vos@einstein.yu.edu
authors.forename: Gabriele
authors.initials: G
authors.lastname: de Vos
authors.forename: Ramin
authors.initials: R
authors.lastname: Nazari
authors.forename: Denisa
authors.initials: D
authors.lastname: Ferastraoaru
authors.forename: Purvi
authors.initials: P
authors.lastname: Parikh
authors.forename: Rebecca
authors.initials: R
authors.lastname: Geliebter
authors.forename: Yikania
authors.initials: Y
authors.lastname: Pichardo
authors.forename: Andrew
authors.initials: A
authors.lastname: Wiznia
authors.forename: David
authors.initials: D
authors.lastname: Rosenstreich
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E