Can Allergen-Specific IgE Antibodies Diagnose Egg Allergy Accurately?

© Copyright The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease http://e-aair.org Diagnosis of food allergy requires thorough history and physical examination, and/or skin prick tests or serum immunoassays to determine food-specific IgE (sIgE) antibodies for IgEmediated food allergy. Double-blind placebo-controlled food challenges (DBPCFC) are actually still the gold standard for diagnosis. Many researchers endeavored to find solutions on diagnosing food allergies without food challenge tests. The traditional DBPCFC tests are time-consuming, expensive and troublesome for physician and patients. Serum immunoassays of food-sIgE has become a widely used modality to evaluate IgEmediated food allergies. Higher concentrations of food-sIgE levels are correlated with an increasing likelihood of clinical allergic reactions but not generally associated with the severity. However, different predictive values are being suggested from recent studies, which might be influenced by diet, age, disease, and challenge protocol. Ethnicity or geographic location can also affect the difference in predictive values because they influence prevalence and causes of food allergies. Moreover, the absence of food-sIgE does not indicate absence of clinical reactions to food. The current international guidelines recommend using oral food challenges (OFC) for diagnosing food allergies. A singleblind or an open-food challenge can be considered diagnostic under careful medical history and physical examination, instead of DBPCFC. Recently, Atopic Dermatitis Study Group in the Korean Academy of Pediatric Allergy and Respitatory Diseases introduced an adjusted guideline for the OFC for Korean children. If a patient has food allergy-suspected symptoms, food-sIgE antibodies would be determined to support the diagnosis. And then, if food-sIgE levels are below the diagnostic values, we can use OFC for diagnosing specific food allergy. In Korea, egg allergy is known as the most frequent food allergy in children, however, large well-designed epidemiological studies are lacking. We still use diagnostic decision points for egg-sIgE levels based on US studies. Namely, we diagnose Can Allergen-Specific IgE Antibodies Diagnose Egg Allergy Accurately?