Food allergy skin prick testing

Eigenmann, P. and Sampson, H.A. 1998. Interpreting skin prick tests in the evaluation of food allergy in children. Pediatr Allergy Immunol 9 186-191. 

Verstege, A., A. Mehl, C. Rolinck-Weminghaus, U. Staden, M. Nocon, K. Beyer, and B. Niggemann. 2005. The predictive value of the skin prick test weal size for the outcome of oral food challenges. Clin Exp Allergy 35 (9) 1220-1226. 

Secondary intervention studies are few. A study in Japan [240(Ib)] identified infants at high risk of house dust mite allergy and asthma postnatally, on the basis of early manifestations of atopy (i.e. eczema and food allergy). Children were enrolled during the 1st year of life and randomised to house dust mite prevention which resulted in a substantial reduction in house dust mite allergen levels. At the 1-year follow-up, children in the active treatment group had lower levels of IgE antibody, prevalence of positive skin prick test responses to house dust mite, and lower incidence of wheezing episodes. Follow-up is awaited. 

In clinical diagnosis of sensitivity to allergens in food, the two methods used most frequently are the skin prick test (SPT) and the radioallergosorbent test (RAST). These tests have been used reliably for the diagnosis of allergy to peas, codfish, peanuts, egg white, wheat and wheat flour but were only partly reliable in detecting allergy to cow s milk, sardines, and white bea ns ( ). 

Most food allergies may be clinically identified through double-blind placebo-controlled crossover food challenge studies. However, due to inherent risks involved in such procedures, food allergies are often identified, at least initially, using a variety of tests either alone or in combination. For example, skin prick tests alone or in combination with patient IgE reactivity assays may be nsed for snch... 

In a patient with occupational allergy to anise seed, a skin prick test showed immediate positive responses to caraway and other spices and foods including coriander, cumin, dill, fennel, and asparagus. Skin prick tests with celery, carrot, birch pollen, and mugwort pollen extracts were negative (Garcia-Gonzalez et al. 2002). 

Prick skin tests are used to screen patients with suspected IgE-mediated food allergies. In Table 3.3.5, there is a list of clinical conditions in which the methods of IgE detection are indicated (Chapman et al., 2006). 

Isolauri, E. and Tumjamaa, K. 1999. Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis. J Allergy Clin Immunol 97 9-15. 

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