Caffarelli C, Cavagni G, Giordano S, Stapane I, Rossi C
Department of Pediatrics, University of Parma, Italy.
J Allergy Clin Immunol. 1995 Jun;95(6):1215-20. doi: 10.1016/s0091-6749(95)70078-1.
Positive skin prick test (SPT) and RAST reactions to egg that had never previously been ingested have been observed in infants with food allergy. The likelihood of having clinical hypersensitivity reactions when egg is first ingested and the predictive value of SPT and RAST remain to be elucidated.
We investigated the relationship between egg-specific IgE antibodies and positive SPT reaction to egg, and the development of clinical hypersensitivity on the first exposure, in infants with food allergy.
The patient group consisted of 21 infants with food allergy and positive SPT and/or RAST reaction to egg, which they had never previously ingested; the control group of 12 infants had food allergy and negative test results. All subjects underwent double-blind placebo-controlled food challenges with egg.
Thirteen of 21 patients (61%) and one of 12 control subjects (8%) had positive reactions to challenges (p < 0.01). Thirteen positive reactions to challenges (93%) elicited immediate symptoms. Late-onset eczema occurred in two children. SPT results showed a high sensitivity (0.92) and negative predictive accuracy (0.92), whereas specificity (0.57) and positive predictive accuracy (0.61) were poor. RAST did not have any diagnostic advantage over SPT.
In infants with food allergy SPT with egg may be helpful in predicting which patients will react to the first exposure.
在食物过敏的婴儿中，观察到对从未摄入过的鸡蛋进行皮肤点刺试验（SPT）和放射性变应原吸附试验（RAST）呈阳性反应。首次摄入鸡蛋时发生临床过敏反应的可能性以及SPT和RAST的预测价值仍有待阐明。
我们研究了食物过敏婴儿中鸡蛋特异性IgE抗体与鸡蛋SPT阳性反应之间的关系，以及首次接触时临床过敏反应的发生情况。
患者组由21名食物过敏且对从未摄入过的鸡蛋SPT和/或RAST反应呈阳性的婴儿组成；12名婴儿的对照组有食物过敏且检测结果为阴性。所有受试者均接受了鸡蛋的双盲安慰剂对照食物激发试验。
21名患者中有13名（61%），12名对照受试者中有1名（8%）对激发试验呈阳性反应（p<0.01）。13例激发试验阳性反应（93%）引发即刻症状。两名儿童出现迟发性湿疹。SPT结果显示敏感性高（0.92）和阴性预测准确性高（0.92），而特异性（0.57）和阳性预测准确性（0.61）较差。RAST与SPT相比没有任何诊断优势。
在食物过敏的婴儿中，鸡蛋SPT可能有助于预测哪些患者会对首次接触鸡蛋产生反应。
