Food allergy, dermatologic diseases, and anaphylaxisA pilot study of the usefulness and safety of a ready-to-use atopy patch test (Diallertest) versus a comparator (Finn Chamber) during cow's milk allergy in children
Section snippets
Patients
A prospective study was carried out between November 2003 and September 2004 in a population of 49 children (mean ± SD age, 34.3 ± 7 months; range, 5-78 months), 18 girls and 31 boys, enrolled after referral to an outpatient clinic for food allergy. Children exhibited at least one symptom of allergy, the main symptoms being atopic dermatitis (n = 5, 10.2%), digestive manifestations (eg, loose stools, colic, vomiting, gastroesophageal reflux, and failure to thrive; n = 20, 40.8%), and combined
Results
Among the 49 enrolled children, 5 (10.2%) exhibited positive specific CMP IgE results, and 1 (2%) had a positive SPT result. Results of the ready-to-use APT and the comparator were positive, respectively, in 22 (44.8%) and 17 (34.6%) patients (not significant) at 48 hours and 22 (44.8%) and 13 (26.5%) patients (not significant) at 72 hours. Both techniques appeared concordant in 32 (65.3%) patients at 48 hours and 33 (67.3%) patients at 72 hours.
Open challenges were carried out in 41 children,
Discussion
Our study shows that in the population of patients with CMA tested, with mostly delayed-onset reactions, the ready-to-use APT exhibited a significantly higher sensitivity (76% vs 44%) and test accuracy (82.9% vs 63.4%) than the comparator, whereas both techniques exhibited high specificity and positive predictive value and were devoid of any side effects.
Several authors underlined the usefulness of the APT in the diagnosis of food allergy in children with atopic dermatitis. In 183 patients with
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Supported by a grant from the pharmaceutical firm DBV-Technologies (Boulogne-Billancourt, France).