Diagnostic accuracy of IgE compared to an open food challenge for detection of egg allergy

StudyPopulation testedPrevalenceDiagnostic accuracy for eggComments
Positive test on challengeImmediate reactionDelayed reactionCombined immediate & delayedSensitivity (%)Specificity (%)PPV (%)NPV (%)
Cantani 1995172

146 children aged 5–48 months with atopic eczema believed to be associated with food allergy45% (44% to milk, 47% egg, 50% other foods)20% (to egg)27% (to egg)2%73 (any reaction)65 (any reaction)57 (any reaction)79 (any reaction)Unclear what a positive test was – assumed mover than 0.35 IU/ml (but 4 classes were used above this level)
90 (immediate reaction)59 (immediate reaction)33 (immediate reaction)96 (immediate reaction)
Monti 2002175

107 children aged 1–19 months (mean 6 months) with atopic eczema who had never eaten egg (directly or indirectly).

The challenges were undertaken when the children were aged 12–24 months.

Atopic eczema was mild in 38%, moderate in 34%, and severe in 28%
67% (49% of those with mild eczema, 79% of those with moderate, and 80% of those with severe eczema).

17% of reactions were exacerbation of eczema.
57%21% early, 17% late6%If IgE >99 ku/l considered positive: 17If IgE >99 ku/l considered positive: 100If IgE >99 ku/l considered positive: 100If IgE >99 ku/l considered positive: 37It is assumed that the accuracy results represent any positive reaction.
If IgE >17.5 ku/l considered positive: 24If IgE >17.5 ku/l considered positive: 100If IgE >17.5 ku/l considered positive: 100If IgE >17.5 ku/l considered positive: 39

NR=not reported

From: Evidence tables

Cover of Atopic Eczema in Children
Atopic Eczema in Children: Management of Atopic Eczema in Children from Birth up to the Age of 12 Years.
NICE Clinical Guidelines, No. 57.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Dec.
Copyright © 2007, National Collaborating Centre for Women’s and Children’s Health.

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