Department of Pediatric Pneumology and Immunology, Charité, Universitätsmedizin, Berlin, Germany.
Allergy. 2010 Dec;65(12):1554-7. doi: 10.1111/j.1398-9995.2010.02429.x.
Hen's egg (HE) allergy is a common disease in childhood. HE-specific serum IgE has been correlated with the outcome of oral food challenge tests, and diagnostic decision points have been described as helpful but still not sufficient to reduce the requirement for oral food challenges. The aim of the study was to correlate HE-specific IgE, IgG and IgG4 levels with the outcome of double-blind, placebo-controlled food challenges (DBPCFC) in patients with suspected HE allergy to improve diagnostic procedures.
HE-specific IgE, IgG, and IgG4 levels were compared between 150 children with suspected HE allergy based on sensitization and/or patient's history who underwent DBPCFC. Sixty-six patients were HE-allergic (HE-sensitized with a positive DBPCFC), 48 HE-sensitized but tolerant (negative DBPCFC), and 36 patients were nonsensitized and tolerant (negative DBPCFC). Prior to food challenge HE-specific serum IgE, IgG, and IgG4 were measured with the Phadia CAP-system.
HE-specific IgE was significantly higher in HE-allergic patients than in clinically tolerant ones. However, there was no difference in HE-specific IgG and IgG4 concentrations between the patient groups.
A proposed cut-off level of 12 kU/l IgE would identify children above this level correctly as HE-allergic. The level of HE-specific IgG or IgG4 in serum of children with suspected HE allergy does not add any additional information in the diagnostic procedure of HE allergy. For diagnostic purposes, specific IgG or IgG4 should not routinely be tested.
鸡蛋（HE）过敏是儿童期常见的疾病。HE 特异性血清 IgE 与口服食物挑战测试的结果相关，并且已经描述了诊断决策点有助于但仍不足以减少口服食物挑战的需求。本研究的目的是将 HE 特异性 IgE、IgG 和 IgG4 水平与疑似 HE 过敏患者的双盲、安慰剂对照食物挑战（DBPCFC）的结果相关联，以改善诊断程序。
根据致敏和/或患者病史，比较了 150 名疑似 HE 过敏的儿童在接受 DBPCFC 时的 HE 特异性 IgE、IgG 和 IgG4 水平。66 名患者为 HE 过敏（DBPCFC 阳性的 HE 致敏），48 名患者为 HE 致敏但耐受（DBPCFC 阴性），36 名患者为非致敏但耐受（DBPCFC 阴性）。在食物挑战之前，使用 Phadia CAP 系统测量了 HE 特异性血清 IgE、IgG 和 IgG4。
HE 过敏患者的 HE 特异性 IgE 明显高于临床耐受患者。然而，两组患者的 HE 特异性 IgG 和 IgG4 浓度没有差异。
建议将 12 kU/l 的 IgE 作为 HE 过敏的 cut-off 值，高于该值的儿童可正确诊断为 HE 过敏。疑似 HE 过敏儿童血清中的 HE 特异性 IgG 或 IgG4 在诊断 HE 过敏的过程中不会提供任何额外信息。出于诊断目的，不应常规检测特异性 IgG 或 IgG4。
