Document Detail

Predictive values for food challenge-induced severe reactions: development of a simple food challenge score.
MedLine Citation:
PMID:  22624438     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Skin-prick tests (SPT), food-specific immunoglobulin E level (sIgE) and clinical history have limited value individually in predicting the severity of outcome of the oral food challenge (OFC).
OBJECTIVES: To develop a score that accounts for SPT, sIgE and clinical history to predict the risk of severe reaction to the OFC.
METHODS: A 5 year retrospective chart review was performed on 983 children who underwent OFC to egg, milk and peanut.
RESULTS: Using multilogistic regression, four major indicators were found to be independently associated with failed OFC: sIgE (odds ratio = 1.04, P < 0.0001), wheal size of the SPT (OR = 1.23, P < 0.0001), a history of any prior reaction to the food (OR = 1.13, P < 0.01), and a history of a prior non-cutaneous reaction (OR = 1.99, P < 0.01); and three were independently associated with anaphylaxis: wheal size (OR = 1.16, P < 0.001), a history of a prior non-cutaneous reaction (OR = 4.24, P < 0.01), and age (OR = 1.07, P < 0.03). A Food Challenge Score (0-4) was developed which accounted for SPT wheal, sIgE, a history of a prior non-cutaneous reaction, and age. A score of 0-1 had a negative predictive value for multisystem reaction to the OFC: 95% for milk, 91% for egg and 93% for peanut. A score of 3-4 had a positive predictive value for anaphylaxis: 62% for milk, 92% for egg and 86% for peanut.
CONCLUSIONS: Severe reaction to milk, egg and peanut OFC can be predicted using a simple score that takes into account clinical data that are commonly available prior to the challenges.
Antonella Cianferoni; Jackie P Garrett; David R Naimi; Karishma Khullar; Jonathan M Spergel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  14     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-05-25     Completed Date:  2012-06-14     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  24-8     Citation Subset:  IM    
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MeSH Terms
Egg Hypersensitivity / complications,  diagnosis
Food Hypersensitivity / complications*,  diagnosis*
Logistic Models
Milk Hypersensitivity / complications,  diagnosis
Peanut Hypersensitivity / complications,  diagnosis
Predictive Value of Tests
ROC Curve
Regression Analysis
Retrospective Studies
Skin Tests
Comment In:
Isr Med Assoc J. 2012 Jan;14(1):48-9   [PMID:  22624443 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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