Department of Pediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Poland.
Adv Med Sci. 2010;55(2):153-60. doi: 10.2478/v10039-010-0038-z.
To evaluate the diagnostic accuracy of the atopy patch test (APT) in detection of delayed-type sensitization to different food allergens, in children with digestive symptoms and with/or without cow's milk allergy.
28 children suspected of food allergy-related gastrointestinal symptoms were underwent diagnostic procedures as skin prick test (SPT), specific immunoglobulin E (sIgE), APT, oral food challenge and then divided into two groups according to the results of oral food challenge: A - 17 children with cow's milk allergy, B - 11 children without cow's milk allergy. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of APT were calculated.
A positive challenge response to milk was found in 60,7% of examined children. No statistical difference in the prevalence of positive SPT and sIgE to milk has been found between the groups. The prevalence of positive APT to other food allergens was significantly higher in children with allergy to milk (p<0,005). No statistical difference of positive APT to other food allergens has been found in children with/or without cow's milk allergy. APT sensitivity and specificity in children with cow's milk allergy obtained on 77%/73%; where PPV obtained on 71%.
High sensitivity and specificity of APT confirm its accuracy in diagnostics of delayed-type reactions in children with gastrointestinal symptoms. Combined atopy patch test and oral food challenge is essential for avoidance of unnecessary elimination diet. Delayed-type sensitization to other food allergens is common in children with cow's milk allergy.
评估变应原斑贴试验（APT）在检测不同食物过敏原迟发型过敏反应中的诊断准确性，用于有胃肠道症状和/或伴有牛奶过敏的儿童。
对 28 例疑似与食物过敏相关的胃肠道症状的儿童进行了皮肤点刺试验（SPT）、特异性免疫球蛋白 E（sIgE）、APT、口服食物激发试验等诊断程序，并根据口服食物激发试验结果将其分为两组：A 组 - 17 例牛奶过敏儿童，B 组 - 11 例非牛奶过敏儿童。计算 APT 的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
60.7%的受试儿童对牛奶有阳性激发反应。两组间牛奶 SPT 和 sIgE 的阳性率无统计学差异。对其他食物过敏原的 APT 阳性率在牛奶过敏儿童中明显更高（p<0.005）。牛奶过敏和非牛奶过敏儿童之间对其他食物过敏原的 APT 阳性率无统计学差异。在牛奶过敏儿童中，APT 的敏感性和特异性分别为 77%/73%；PPV 为 71%。
APT 的高敏感性和特异性证实了其在诊断有胃肠道症状的儿童迟发型反应中的准确性。结合 APT 和口服食物激发试验对于避免不必要的饮食排除是必要的。牛奶过敏儿童中常见对其他食物过敏原的迟发型过敏反应。
