title: Oral challenge tests for soybean allergies in Japan: A summary of 142 cases.
abstract: BACKGROUND
  Soybeans are one of causative foods for infantile onset allergies in Japan. This study aimed to analyze the results of soybean challenge tests that were conducted over approximately 7 years at our institution. Using the test data, we sought to identify the responses and clinical profiles of patients with soybean allergies, and to investigate the relationship between the responses and soybean sensitization status.
  
  
  METHODS
  Between July 2004 and May 2010, 142 cases (125 patients) underwent food challenge tests (100 g of silken tofu) for the diagnosis of soybean allergy or confirmation of their tolerance. The patients' characteristics, soybean sensitization status, and responses to the challenge tests were retrospectively evaluated.
  
  
  RESULTS
  Among the subjects who underwent the soybean challenge test, the male/female ratio was 1.6 (87/55), and the mean age at the test was 2.8 ± 1.7 years. The positive rate for the challenge test was 38.7%. Induced symptoms were observed in the skin (81.8%), respiratory system (50.9%), and gastrointestinal system/mucosal membrane/anaphylaxis (12.7%). Intramuscular epinephrine was administered to all 7 patients who experienced an anaphylactic reaction. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency of soybean-specific IgE titers were low for predicting the responses to the challenge test.
  
  
  CONCLUSIONS
  Soybean allergies were diagnosed in only 18% of the subjects with positive sensitization to soybeans. Therefore, soybean-specific IgE titers are not an effective predictor of a positive response to the challenge test.
authors.affiliation: Department of Pediatrics, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Shukuya
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Sakura
authors.initials: S
authors.lastname: Sato
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Komata
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Utsunomiya
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan; Department of Pediatrics, Showa University, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Imai
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Morimitsu
authors.initials: M
authors.lastname: Tomikawa
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan. Electronic address: m-ebisawa@sagamihara-hosp.gr.jp.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007114:Immunization / Q000379:methods; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012882:Skin Tests; D013025:Glycine max / Q000009:adverse effects*
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: Allergic reaction; Food challenge test; IgE; Sensitization; Soybeans