Diagnosis of allergy in different age groups of children: use of mixed allergen RAST discs, Phadiatop and Paediatric Mix.

Childhood asthma often begins in children under 3 years of age. Allergy contributes to the severity and persistence of childhood asthma so we examined the application of mixed allergen RAST discs (Paediatric Mix, a mixture of food antigens and Phadiatop, a mixture of inhalants) to the diagnosis of allergy. One hundred and nine children with a median age of 3 years, 71.6% of whom had asthma, were first assessed by one allergist who recorded their atopic status as positive, negative or questionable, on clinical grounds. Serum from each of these patients was used to determine a total IgE and 13 RAST assays. A laboratory definition of atopy was defined as a serum IgE greater than 1 standard deviation from normal, plus one or more positive RAST assays. The laboratory results influenced the assessment of atopy in 41% of cases. The use of just two mixed allergen discs (Paediatric Mix and Phadiatop) correctly assigned the presence or absence of atopy with a sensitivity of 98% and specificity of 98%, compared with the full laboratory evaluation. Very young infants were often just positive to food allergens but the Phadiatop disc could be used to suggest the onset of immunological sensitivity to inhalant antigens. Thus the application of mixed allergen RAST discs facilitated the diagnosis of atopy in young children.