Parrish Christopher P
Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Ann Allergy Asthma Immunol. 2023 Oct;131(4):421-426. doi: 10.1016/j.anai.2023.04.011. Epub 2023 Apr 23.
Serum immunoglobulin E (IgE) assays to food specific IgE (s-IgE) are useful tools for the confirmation of clinical suspicion of food allergy. However, the specificity of these assays is poor given that sensitization is much more common than clinical food allergy. Therefore, the use of broad panels to assess sensitization to multiple foods often leads to overdiagnosis and unnecessary food avoidance. Unintended consequences that may occur as a result include physical harm, psychological harm, financial cost, opportunity cost, and even worsening of existing health care disparities. Although current guidelines recommend against the use of s-IgE food panel testing, these tests are widely available and frequently used. To limit the negative impacts of s-IgE food panel testing, further work is needed to effectively spread the message that these food panels may cause unintended harm to patients and families.
针对食物特异性免疫球蛋白E（IgE）的血清免疫球蛋白E（s-IgE）检测是用于确诊临床怀疑食物过敏的有用工具。然而，鉴于致敏比临床食物过敏更为常见，这些检测的特异性较差。因此，使用广泛的检测组来评估对多种食物的致敏情况往往会导致过度诊断和不必要的食物回避。可能由此产生的意外后果包括身体伤害、心理伤害、经济成本、机会成本，甚至会加剧现有的医疗保健差距。尽管当前指南不建议使用s-IgE食物检测组，但这些检测广泛可得且经常被使用。为了限制s-IgE食物检测组的负面影响，需要进一步开展工作，以有效地传播这样的信息，即这些食物检测组可能会对患者及其家庭造成意外伤害。
