Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY.
J Allergy Clin Immunol Pract. 2013 Jan;1(1):1-13; quiz 14. doi: 10.1016/j.jaip.2012.10.004. Epub 2012 Dec 27.
Peanut allergy is often severe, potentially fatal, usually persistent, and appears to have increased in prevalence. An accurate diagnosis is essential because there is a significant burden on quality of life. The tools available for diagnosis include the medical history, skin prick test (SPT), determination of serum peanut-specific IgE antibodies (PN-IgE), and medically supervised oral food challenges. Numerous studies, almost exclusively in children, have correlated clinical outcomes against SPTs and PN-IgE with informative results. The diagnostic utility of SPT and PN-IgE is maximized by considering the degree of positive result and consideration of the medical history (a priori estimation of risk). Emerging tests that evaluate IgE binding to specific proteins in peanut (component testing) add important additional diagnostic information in specific settings. Studies are increasingly focused on how the results of tests considered in combination (or performed serially) may increase diagnostic accuracy. Here, we review the utility of currently available tests and provide suggestions on how to best use them to accurately predict peanut allergy. Still, the physician-supervised oral food challenge remains the most definitive test available.
花生过敏通常较为严重，可能致命，且往往持续存在，发病率似乎有所上升。准确的诊断至关重要，因为这会对生活质量造成重大影响。目前可用于诊断的工具包括病史、皮肤点刺试验（SPT）、血清花生特异性 IgE 抗体（PN-IgE）测定和医学监督下的口服食物挑战。大量研究（几乎全部在儿童中进行）对 SPT 和 PN-IgE 与临床结果进行了相关性分析，结果具有参考意义。考虑到阳性结果的程度以及病史（风险的预先评估），可最大程度提高 SPT 和 PN-IgE 的诊断效用。在特定情况下，评估花生中 IgE 与特定蛋白结合的新兴检测（组分检测）可提供重要的额外诊断信息。研究越来越关注联合（或连续进行）考虑的检测结果如何提高诊断准确性。在此，我们回顾了目前可用检测的效用，并就如何最好地使用它们来准确预测花生过敏提供了建议。不过，医生监督下的口服食物挑战仍然是最准确的检测方法。
