Is food allergy testing reliable in pediatric atopic dermatitis? A population-based study

Laura E. Keck, Eric L. Simpson, Trista M. Berry, Jon Hanifin

Research output: Chapter in Book/Report/Conference proceedingChapter

6 Scopus citations


We sought to assess the value and reliability of serologic testing for predicting clinical food allergy in a population-based cohort of infants with atopic dermatitis (AD). Infants 3-18 months of age, recruited from the general population, were followed quarterly for 3 years and carefully evaluated for evidence of immediate reactions to foods. Specific serum IgE levels for six foods were assayed at 3-5 years. Parents were interviewed at each visit regarding past/current immediate food-specific reactions involving skin, gut or respiratory systems. Data were entered into Excel for calculations of performance characteristics. Nine of the 40 patients (23%) who completed 3 years of follow-up had reactions to one or more foods. Reactions occurred in 5, 11 and 18% to milk, peanut and egg ingestion, respectively. In contrast, 30% of food-specific serum IgE tests were above normal. Predictive reliability of tests was generally low unless values were in the high range for peanut and milk. Conversely, egg allergy could be seen across a nearly full-spectrum of IgE values, making prediction highly unreliable. We conclude that physician and patient misinterpretation of the relevance and reliability of allergy testing may misdirect proper prevention and therapy of AD.

Original languageEnglish (US)
Title of host publicationNew Trends in Allergy and Atopic Eczema
EditorsJohannes Ring, Heidrun Behrendt, Ulf Darsow
Number of pages5
StatePublished - Mar 2012

Publication series

NameChemical Immunology and Allergy
ISSN (Print)1660-2242
ISSN (Electronic)1662-2898

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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