Discordance between aeroallergen specific serum IgE and skin testing in children younger than 4 years
Open accessAbstract
Background Atopic sensitization to aeroallergens in early life has been found to be a strong risk factor for the development of persisting asthma in young children with recurrent wheeze.Objective To assess the yield of skin prick test (SPT) compared with allergen specific serum IgE (sIgE) testing at identifying aeroallergen sensitization in atopic children younger than 4 years.Methods Concordance between SPT and allergen-specific sIgE testing for 7 common aeroallergens was analyzed in 40 atopic inner-city children 18 to 48 months of age (mean [SD], 36 [9] months) with recurrent wheezing and family history of asthma and/or eczema.Results In 80% of children one or more allergen sensitizations would have been missed if only SPT had been performed, and in 38% of children one or more sensitizations would have been missed if only sIgE testing had been performed. Agreement between the SPT and sIgE test was fair for most allergens (κ = -0.04 to 0.50), as was correlation between sIgE levels and SPT grade (ρ = 0.21 to 0.55). Children with high total sIgE (≥300 kU/L) were more likely to have positive sIgE test results, with negative corresponding SPT results (P = .02).Conclusion Our study revealed a significant discordance between allergen-specific SPT and sIgE testing results for common aeroallergens, suggesting that both SPT and sIgE testing should be performed when diagnosing allergic sensitization in young children at high risk of asthma.Trial registration clinicaltrials.gov Identifier: NCT01028560.
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Modern SPT of aeroallergens can be up to 25% more sensitive than specific IgE serology depending on the patient population and methodologies employed.
“Modern SPT of aeroallergens can be up to 25% more sensitive than sIgE serology depending on the patient population and the methodologies employed.793,930-934”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [931]
The Results and Discussion (pages not available) report the opposite comparison in the children studied: SPT alone would have missed an average of 42% of sensitizations, versus 13% with sIgE serology alone. The paper finds discordance between the tests, but does not report SPT as up to 25% more sensitive. (LLM, conf=0.85)
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Experimental — accuracy not yet measuredIntradermal or epicutaneous testing demonstrates higher sensitivity but lower specificity than SPT for several allergens.
“Intradermal or epicutaneous testing demonstrates higher sensitivity but lower specificity than SPT for several allergens.793,856,931,932,944”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [931]
The Methods and Results compare skin-prick testing with serum-specific IgE testing, not with intradermal or epicutaneous testing. The Discussion describes discordant results but does not establish the claimed sensitivity–specificity trade-off for those methods (pages unavailable in our copy). (LLM, conf=0.78)
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References 18 · Cited by 34
- Authors
- de Vos, G., Nazari, R., Ferastraoaru, D., Parikh, P., Geliebter, R., Pichardo, Y., Wiznia, A., & Rosenstreich, D.
- Affiliations
- Albert Einstein College of Medicine (US)
- Jacobi Medical Center (US)
- Venue
- Annals of Allergy, Asthma & Immunology
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 110
- Issue
- 6
- Pages
- 438-443
- ISSN
- 1081-1206 (ISSN-L)
- PMC
- PMC4529057
- OpenAlex
- W2110588930
- Cited by
- 34
- References
- 18
- Citations by year
- 2026: 2 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 5 · 2014: 3 · 2013: 1
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Allergy Asthma & Immunology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Institute for Clinical and Translational Research, University of Wisconsin, Madison
- National Center for Research Resources (UL1RR025750, KL2RR025749, TL1RR025748)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- aeroallergen sensitization, specific IgE, skin prick test, test concordance, young children, recurrent wheezing, atopic sensitization, asthma risk, total IgE, allergen testing
- MeSH terms
- Adult, Allergens, Antibody Specificity, Child, Preschool, Female, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Infant, Infant, Newborn, Male, Middle Aged, Skin Tests, Reproducibility of Results
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