Traiyan Sasiwimon, Manuyakorn Wiparat, Kanchongkittiphon Watcharoot, Sasisakulporn Cherapat, Jotikasthira Wanlapa, Kiewngam Potjanee, Kamchaisatian Wasu, Benjaponpitak Suwat
Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Am J Rhinol Allergy. 2021 Jan;35(1):98-106. doi: 10.1177/1945892420938300. Epub 2020 Jun 27.
Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization.
To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard.
Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens.
One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%.
SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.
皮肤点刺试验(SPT)或多过敏原免疫球蛋白E筛查试验Phadiatop被用作检测气传变应原致敏的工具。
以鼻激发试验(NPT)作为比较标准,比较SPT和Phadiatop作为诊断变应性鼻炎(AR)的工具。
纳入过去一年鼻炎症状发作超过6次的5至18岁儿童。进行针对13种常见气传变应原的SPT、Phadiatop血清检测以及针对(Der p)的NPT。对蟑螂(CR)致敏且对Der p的NPT结果为阴性的儿童进行混合蟑螂(CR)的NPT。对SPT和Phadiatop结果不一致或结果为阴性的儿童检测常见气传变应原的特异性免疫球蛋白E(sIgE)。
共纳入140名儿童,平均年龄9.8±3岁,56%为男性。在92名(65.7%)对任何气传变应原SPT呈阳性的儿童中,88名(95.6%)对屋尘螨(HDM)致敏。NPT结果显示97名儿童(69.3%)呈阳性。在48名SPT结果为阴性的儿童中,4名(8.3%)有变应原sIgE,但NPT结果1名儿童呈阳性。88名儿童(62.9%)Phadiatop检测呈阳性,其中4名(4.5%)对Der p的NPT结果为阴性。在52名Phadiatop结果为阴性的儿童中,4名(7.6%)有变应原sIgE,但NPT结果2名儿童(3.8%)呈阳性。SPT和Phadiatop的一致性为94.2%:Kappa值为0.876,p<0.001。以NPT作为AR诊断的比较标准,SPT的敏感性为89.6%,特异性为88.3%,Phadiatop的敏感性为88.6%,特异性为95.3%。
气传变应原SPT和Phadiatop在儿童AR诊断中具有良好且相当的敏感性和特异性。