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Allergic children with extremely high total IgE but no allergen identified in the initial screening panel.

Authors
  • Lin, I-Hui1
  • Tsai, Ming-Chin1
  • Chen, Jun-Peng2
  • Fu, Lin-Shien3
  • 1 Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan. , (Taiwan)
  • 2 Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan. , (Taiwan)
  • 3 Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan. Electronic address: [email protected] , (Taiwan)
Type
Published Article
Journal
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi
Publication Date
Jun 01, 2021
Volume
54
Issue
3
Pages
474–481
Identifiers
DOI: 10.1016/j.jmii.2020.01.001
PMID: 32059831
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

High serum IgE level in atopic children usually implies a highly sensitized condition. However, there is a subgroup of atopic children for whom a specific allergen cannot be identified. In this study, we analyzed follow-up data from these children. From March 2014 to July 2017, we recruited 14 atopic children with serum total IgE level higher than 500 Ku/L, but with no specific allergen identified by repeated MAST tests initially. Follow-up studies of specific IgE were conducted by the OPTIGEN MAST Allergy test and ImmunoCAP assays (Thermo Fisher Scientific/Phadia), while total IgE and specific IgG were measured by ImmunoCAP. The patients were aged from 2 to 17 y/o. The follow-up MAST tests showed significantly positive results in 10 patients. There were no significant differences in any of the clinical characteristics between the MAST-positive and MAST-negative groups. In the MAST-negative group, five allergen-specific IgE antibodies, including those for cockroach, Euroglyphus maynei, Blomia tropicalis, shrimp, and crab, were strongly predictive of negative ImmunoCAP results, according to ROC (Receiver operating characteristic curve) analysis of the AUC (Area under the Curve of ROC) (0.70-0.95), with significance set at p < 0.05. In two thirds of atopic children with a high serum IgE whose specific allergen had yet to be identified, it was possible to identify the specific MAST allergen(s) after an average follow-up of 33.2 months. For patients who still had negative results in follow-up MAST, mite DP, DF, and DM may be suitable choices for further allergen identification by ImmunoCAP. Copyright © 2020. Published by Elsevier B.V.

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