特应性皮炎患儿的特应性斑贴试验。
Atopy patch test in children with atopic dermatitis.
机构信息
Division of Allergy and Immunology, Faculty of Medicine, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Allergy and Immunology, Faculty of Medicine, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Ann Allergy Asthma Immunol. 2016 Dec;117(6):668-673. doi: 10.1016/j.anai.2016.09.446.
BACKGROUND
Atopic dermatitis is frequently associated with food and/or aeroallergen allergy.
OBJECTIVE
To evaluate atopy patch tests (APTs) and skin prick tests (SPTs) in children with atopic dermatitis, using allergen extracts from locally lyophilized foods (cow's milk, egg white, egg yolk, wheat, soy, and shrimp), Dermatophagoides pteronyssinus, Dermatophagoides farinae, and American cockroach.
METHODS
This study was a prospective, self-controlled study in children with atopic dermatitis. APTs, SPTs, and oral food challenge tests were performed in the cases with written informed consent.
RESULTS
Fifty-six children with atopic dermatitis were enrolled. According to the Severity Scoring of Atopic Dermatitis Index, moderate atopic dermatitis was the most common severity (49.1%) followed by mild (20%) and severe atopic dermatitis (13.2%). APT results were positive for food allergens in 49% of participants; SPT results were positive in 54.7%. The sensitivity, specificity, positive predictive value, and negative predictive value of APTs for foods were 40%, 90.2%, 65.2%, and 76.6%, respectively. For SPTs, those values were 40%, 93.9%, 75%, and 77.3%, respectively. APT results for D farinae, D pteronyssinus, and American cockroach were positive in 33.9%, 35.8%, and 21.8% of participants, respectively. SPT results for these allergens were positive in 28.3%, 24.5%, and 9.4% of participants, respectively. No serious complications occurred.
CONCLUSION
APTs with locally prepared lyophilized allergen extracts were safe and had high specificity, median positive predictive value, and low sensitivity for evaluation of suspected food allergy in children with atopic dermatitis.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT01164293.
背景
特应性皮炎常与食物和/或变应原过敏有关。
目的
评估特应性皮炎患儿的特应性斑贴试验（APT）和皮肤点刺试验（SPT），使用本地冻干食物（牛奶、蛋清、蛋黄、小麦、大豆和虾）、屋尘螨、粉尘螨和美洲蟑螂的变应原提取物。
方法
这是一项在特应性皮炎患儿中进行的前瞻性、自身对照研究。在有书面知情同意书的情况下，进行 APT、SPT 和口服食物激发试验。
结果
共纳入 56 例特应性皮炎患儿。根据特应性皮炎严重程度评分指数，中度特应性皮炎最常见（49.1%），其次是轻度（20%）和重度特应性皮炎（13.2%）。APT 对食物变应原的阳性率为 49%；SPT 阳性率为 54.7%。APT 对食物的敏感性、特异性、阳性预测值和阴性预测值分别为 40%、90.2%、65.2%和 76.6%。SPT 分别为 40%、93.9%、75%和 77.3%。D 尘螨、D 屋尘螨和美洲蟑螂的 APT 结果阳性率分别为 33.9%、35.8%和 21.8%。这些过敏原的 SPT 结果阳性率分别为 28.3%、24.5%和 9.4%。未发生严重并发症。
结论
使用本地制备的冻干变应原提取物进行 APT 安全且特异性高，对特应性皮炎患儿疑似食物过敏的评估具有较高的阳性预测值和较低的敏感性。
试验注册
clinicaltrials.gov 标识符：NCT01164293。
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