Highly accurate prediction of food challenge outcome using routinely available clinical data

DunnGalvin, Audrey; Daly, Deirdre; Cullinane, Catherine; Stenke, Emily; Keeton, Diane; Erlewyn-Lajeunesse, Michel; Roberts, Graham; Lucas, Jane S.; Hourihane, Jonathan

doi:10.1016/j.jaci.2010.12.004

Cited by 107 publications

(103 citation statements)

References 39 publications

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“…This finding was somewhat surprising given prior evidence which suggests that non-Hispanic black children have higher levels of IgE levels than non-Hispanic white children [1,3]. IgE levels do not necessarily correspond to the presence or severity of clinical allergies [16], but at the same time, our reported measure of allergy severity may also have limitations which are discussed below. We also found no evidence of race/ethnicity or poverty status differences in healthcare characteristics by food allergy severity among food allergic children.…”

Section: Discussionmentioning

confidence: 65%

Among Children with Food Allergy, Do Sociodemographic Factors and Healthcare Use Differ by Severity?

Branum

Simon

Lukacs

2012

Matern Child Health J

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Section: Discussionmentioning

confidence: 65%

Among Children with Food Allergy, Do Sociodemographic Factors and Healthcare Use Differ by Severity?

Branum

Simon

Lukacs

2012

Matern Child Health J

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“…3 Our goal was to maximize the proportion of negative OFCs within this group. A previous study 13 reported negative OFCs among children with higher FSIgE values. DunnGalvin et al 13 sought to develop a model that might replace OFCs in diagnosing food allergy.…”

Section: Discussionmentioning

confidence: 79%

“…We do not fully understand the mechanism behind this finding, but similar (albeit not significant) trends were previously reported in statistical models that were designed to predict results of OFC to milk. 13 Eating egg as an ingredient in baked goods was common among our egg-allergic children (42%) and was the factor most strongly associated with negative OFC to egg. This finding is consistent with recent data suggesting that, in a subset of egg-allergic children, ingestion of heated egg is well tolerated and might facilitate tolerance.…”

Section: Discussionmentioning

confidence: 85%

“…12,13 We extended this approach to the clinical scenario aimed at increasing the accuracy of identifying children who will experience negative OFCs. We aimed to investigate if there are food-specific combinations of clinical and laboratory characteristics that define subgroups of children, undergoing OFC based on the guideline-recommended FSIgE levels, 3 who are most likely to experience a negative OFC.…”

mentioning

confidence: 99%

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Clinical and laboratory factors associated with negative oral food challenges

Beigelman

Strunk²,

Garbutt³

et al. 2012

allergy asthma proc

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Children 2 Oral food challenges (OFCs) are the recommended procedure to document the resolution of food allergy, 3,4 but they are time-consuming, difficult to perform, require resources, and expose the patient to the risk of a significant allergic reaction. Food-specific IgE (FSIgE) levels have been used to predict the outcome of OFC because FSIgE levels above certain cut points were found to be highly predictive of positive OFCs.5-10 However, FSIgE levels are less effective in identifying children who experience a negative OFC. 11In clinical practice, children with a known food allergy are considered appropriate candidates for OFCs to evaluate for resolution of food allergy when the likelihood of a positive OFC is Յ50%.3 Previous research 11 has revealed that FSIgE of Յ2 kUa/L (or Յ5 kUa/L for peanuts without a history of previous reaction) are associated with an estimated Յ50% likelihood of reacting to eggs, milk, or peanuts during an OFC, and these FSIgE values have been incorporated into clinical guidelines.11 Identifying additional clinical and laboratory factors associated with negative OFC within this group of patients would improve patient care by decreasing the number of unnecessary (i.e., predictably positive) OFCs.Recently, it was shown that the incorporation of clinical and laboratory data to supplement FSIgE levels effectively diagnosed food allergy and might eliminate the need for some OFCs to confirm the presence of food allergy. 12,13 We extended this approach to the clinical scenario aimed at increasing the accuracy of identifying children who will experience negative OFCs. We aimed to investigate if there are food-specific combinations of clinical and laboratory characteristics that define subgroups of children, undergoing OFC based on the guideline-recommended FSIgE levels, 3 who are most likely to experience a negative OFC.

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“…When validated in the same centre, the model showed an AUC of 0.97 to predict peanut allergy (33). However, this prediction model was not able to predict peanut allergy in a Dutch study (34).…”

Section: Algorithm For the Diagnosis Of Cashew Nut Allergymentioning

confidence: 92%

Systematic review on cashew nut allergy

Valk

Dubois

Wijk

et al. 2014

Allergy

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Recent studies on cashew nut allergy suggest that the prevalence of cashew nut allergy is increasing. Cashew nut consumption by allergic patients can cause severe reactions, including anaphylaxis. This review summarizes current knowledge on cashew nut allergy to facilitate timely clinical recognition and to promote awareness of this emerging food allergy amongst clinicians. The goal of this study is to present a systematic review focused on the clinical aspects of allergy to cashew nut including the characteristics of cashew nut, the prevalence, allergenic components, cross-reactivity, diagnosis and management of cashew nut allergy. The literature search yielded 255 articles of which 40 met our selection criteria and were considered to be relevant for this review. The 40 articles included one prospective study, six retrospective studies and seven case reports. The remaining 26 papers were not directly related to cashew nut allergy. The literature suggests that the prevalence of cashew nut allergy is increasing, although the level of evidence for this is low. A minimal amount of cashew nut allergen may cause a severe allergic reaction, suggesting high potency comparable with other tree nuts and peanuts. Cashew allergy is clearly an underestimated important healthcare problem, especially in children.Although peanut allergy has been on the increase for two decades or more, studies indicate that cashew nut is also becoming an important food allergen (1, 2). The rapid increase in consumption of cashew nuts and the change in eating and cooking habits may be responsible for the increasing significance of cashew nut allergy (2).In this paper, we summarize the relevant information available on epidemiology, allergen components, clinical features, diagnosis, clinical and in vitro cross-sensitization and management of cashew nut allergy. Data sources and literature searchIn our search, we adhered to the methods and procedures of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for reporting this systematic review, excluding irrelevant items. Registration number in PROSPERO is CRD42013004047.We used Ovid MEDLINE and EMBASE databases to identify relevant articles using the string: (Anacardi* sensitiv*) OR allerg*): de, ab, ti for EMBASE. We also checked references to relevant articles ('snowballing').We aimed to include studies focused on the clinical aspects of cashew nut allergy. We considered only studies in English. There was no restriction on publication date. Mouse model studies were excluded. Initially, all articles on cashew nut allergy or on cashew nuts were included. Thereafter articles on contact dermatitis, genetics, product labelling, poisoning, detection methods and possible medicinal effects of cashew plants were excluded. Forty of 255 articles found with the literature search (244 articles) and by 'snowballing (11 articles) were considered relevant for the review. Of these 40 articles, one article was a prospective study and six articles were retrospective stu...

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Highly accurate prediction of food challenge outcome using routinely available clinical data

Cited by 107 publications

References 39 publications

Among Children with Food Allergy, Do Sociodemographic Factors and Healthcare Use Differ by Severity?

Among Children with Food Allergy, Do Sociodemographic Factors and Healthcare Use Differ by Severity?

Clinical and laboratory factors associated with negative oral food challenges

Systematic review on cashew nut allergy

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