Allergy Asthma Immunol Res.  2016 Mar;8(2):156-160. 10.4168/aair.2016.8.2.156.

Diagnostic Value of Specific IgE to Peanut and Ara h 2 in Korean Children with Peanut Allergy

• Kim HY
• Han Y
• Kim K
• Lee JY
• Kim MJ
• Ahn K
• Kim J

• KMID: 2165932
• DOI: http://doi.org/10.4168/aair.2016.8.2.156

Abstract

PURPOSE
The purpose of this study was to establish the diagnostic decision point (DDP) of peanut specific IgE (sIgE) for predicting the outcome of oral food challenge (OFC). We also evaluated the usefulness of sIgE to peanut components (Ara h 1, 2, 3, 8, and 9) in diagnosing peanut allergy.
METHODS
Korean children aged over 12 months with a suspected peanut allergy were enrolled. Diagnosis of peanut allergy was confirmed by an open OFC or through the convincing history of anaphylaxis. Cutoff levels of sIgE to peanut and peanut components were determined by analyzing receiver operating characteristic curves.
RESULTS
Forty-eight children (22 boys and 26 girls) with a suspected peanut allergy were enrolled. The previously established DDP for peanut-sIgE antibodies (14 kU/L) showed a sensitivity of 22.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value of 60.4% in our study population. The median levels of peanut-sIgE (5.4 kU/L vs 1.1 kU/L, P<0.001) and Ara h 2-sIgE (0.8 kU/L vs 0 kU/L, P<0.001) were significantly higher in the peanut allergy group than in the peanut tolerance group. The peanut-sIgE concentration indicating a PPV of 100% was 10.3 kU/L. The Ara h 2-sIgE level of 4.0 kU/L had a PPV of 100%.
CONCLUSIONS
Our results showed that the cutoff levels for peanut (10.3 kU/L) and Ara h 2 (4.0 kU/L) established in this study is useful for the diagnosis of peanut allergy in Korean children.

Keyword

Food allergy; peanut allergy; specific IgE

MeSH Terms

Anaphylaxis
Antibodies
Child*
Diagnosis
Food Hypersensitivity
Humans
Immunoglobulin E*
Peanut Hypersensitivity*
ROC Curve
Sensitivity and Specificity
Antibodies
Immunoglobulin E

Figure

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  Fig. 1 Flowchart of the study population.

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  Fig. 2 Comparison of level of specific IgE against peanut, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9 between the peanut-tolerance group and peanut-allergy group. Each box plot indicates an interquartile range (IQR) with median, upper and lower whiskers; upper and lower boundaries (3rd quartile/1st quartile± 1.5 IQR). *P value <0.05. T, peanut-tolerance group; A, peanut-allergy group.

• 

  Fig. 3 ROC analysis using specific IgE against peanut and peanut components (Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9) for the diagnosis of peanut allergy. sIgE, specific IgE; PPV, positive predictive value; NPV, negative predictive value.

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