van Toorenenbergen A W, Oranje A P, Vermeulen A M, Aarsen R S
Afd. Klinische Chemie, laboratorium Allergologie, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Ned Tijdschr Geneeskd. 1991 Oct 12;135(41):1920-3.
The aim of this study was to evaluate a new test for IgE antibody screening in children--the Phadiatop Paediatric. The mixture of allergens in this test contains the food and inhalant allergens for infants and children most relevant. 180 sera were selected from samples submitted for routine diagnostic IgE antibody assay. 91% of these sera were from children less than 5 year old. Half the sera were positive in RASTs that were initially requested by the physicians and the highest RAST scores for each serum were equally distributed over the range RAST class 1-4. 20 control sera were from children 1-4 years old. Results of the Phadiatop Paediatric were compared with results of the combination 'Phadiatop + mixed-food-RAST'. 22% of the sera that were negative in all RASTs that were initially requested by the physicians were positive in both tests. This suggests that an IgE antibody response to food components or inhalants was underdiagnosed in these cases. Whereas 135 sera were found positive in the Phadiatop Paediatric, only 116 sera had a positive Phadiatop result and/or a result of the mixed-food-RAST that was RAST class 1 (greater than or equal to 0.35 PRU/ml) or higher. In 11 of 16 sera with RAST class 0/1 (0.18-0.35 PRU/ml) in the mixed-food-RAST specific IgE against individual food allergens with RAST class 1 or higher could be demonstrated. Results of Phadiatop and Phadiatop Paediatric were not only expressed as 'positive' or 'negative', but also as a serum:reference ratio. Clinical documentation was collected retrospectively from the written case reports of 171 children.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估一种用于儿童IgE抗体筛查的新检测方法——儿童速发型变态反应综合诊断试验(Phadiatop Paediatric)。该检测中的变应原混合物包含对婴幼儿和儿童最具相关性的食物和吸入性变应原。从提交进行常规诊断性IgE抗体检测的样本中选取了180份血清。其中91%的血清来自5岁以下儿童。一半的血清在医生最初要求的放射变应原吸附试验(RAST)中呈阳性,且每份血清的最高RAST评分在RAST 1 - 4级范围内均匀分布。20份对照血清来自1 - 4岁儿童。将儿童速发型变态反应综合诊断试验的结果与“速发型变态反应综合诊断试验 + 混合食物RAST”组合的结果进行比较。在医生最初要求的所有RAST中均为阴性的血清中,有22%在这两种检测中呈阳性。这表明在这些病例中,对食物成分或吸入物的IgE抗体反应未得到充分诊断。虽然在儿童速发型变态反应综合诊断试验中有135份血清呈阳性,但只有116份血清的速发型变态反应综合诊断试验结果为阳性和/或混合食物RAST结果为RAST 1级(大于或等于0.35 PRU/ml)或更高。在混合食物RAST中RAST为0/1级(0.18 - 0.35 PRU/ml)的16份血清中,有11份可以证明针对个体食物变应原的特异性IgE为RAST 1级或更高。速发型变态反应综合诊断试验和儿童速发型变态反应综合诊断试验的结果不仅以“阳性”或“阴性”表示,还以血清与参照的比例表示。临床记录是从171名儿童的书面病例报告中回顾性收集的。(摘要截选于250词)