特应性斑贴试验在评估食物过敏相关的特应性皮炎中是否可靠？

Is the Atopy Patch Test Reliable in the Evaluation of Food Allergy-Related Atopic Dermatitis?

作者信息

Mansouri Mahboubeh, Rafiee Elham, Darougar Sepideh, Mesdaghi Mehrnaz, Chavoshzadeh Zahra

机构信息

Department of Immunology and Allergy, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int Arch Allergy Immunol. 2018;175(1-2):85-90. doi: 10.1159/000485126. Epub 2018 Jan 13.

DOI:10.1159/000485126

PMID:29332097

Abstract

BACKGROUND

Aeroallergens and food allergens are found to be relevant in atopic dermatitis. The atopy patch test (APT) can help to detect food allergies in children with atopic dermatitis. This study evaluates if the APT is a valuable tool in the diagnostic workup of children with food allergy-related atopic dermatitis.

METHODS

42 children between 6 months and 12 years of age were selected at the Mofid Children Hospital. Atopic dermatitis was diagnosed, and the severity of the disease was determined. At the test visit, the patients underwent a skin prick test (SPT), APT, and serum IgE level measurement for cow's milk, egg yolk, egg white, wheat, and soy.

RESULTS

We found a sensitivity of 91.7%, a specificity of 72.7%, a positive predictive value (PPV) of 88%, a negative predictive value (NPV) of 80%, and an accuracy of 85.7% for APT performed for cow's milk. APT performed for egg yolk had a sensitivity and a NPV of 100%, while the same parameters obtained with egg white were 84.2 and 75%, respectively. The sensitivity, specificity, and NPV of the APT for wheat were 100, 75, and 100%, respectively. The sensitivity, PPV, and NPV of the APT for soy were 87.5, 70, and 87.5%, respectively.

CONCLUSIONS

Our data demonstrate that the APT is a reliable diagnostic tool to evaluate suspected food allergy-related skin symptoms in childhood and infancy.

摘要

背景

已发现气传变应原和食物变应原与特应性皮炎相关。特应性斑贴试验（APT）有助于检测患有特应性皮炎的儿童的食物过敏。本研究评估APT是否是诊断与食物过敏相关的特应性皮炎儿童的有价值工具。

方法

在莫菲德儿童医院选取42名6个月至12岁的儿童。诊断特应性皮炎，并确定疾病的严重程度。在测试就诊时，患者接受了皮肤点刺试验（SPT）、APT以及针对牛奶、蛋黄、蛋清、小麦和大豆的血清IgE水平测量。

结果

我们发现针对牛奶进行的APT的敏感性为91.7%，特异性为72.7%，阳性预测值（PPV）为88%，阴性预测值（NPV）为80%，准确率为85.7%。针对蛋黄进行的APT的敏感性和NPV均为100%，而针对蛋清获得的相同参数分别为84.2%和75%。针对小麦的APT的敏感性、特异性和NPV分别为100%、75%和100%。针对大豆的APT的敏感性、PPV和NPV分别为87.5%、70%和87.5%。