Fogg MI, Brown-Whitehorn TA, Pawlowski NA, Spergel JM. Pediatr Allergy Immunol. 2006;17:351–355
PURPOSE OF THE STUDY. This prospective study was undertaken to determine if the atopy patch test (APT) is able to predict the results of the oral food challenge (OFC) for food protein–induced enterocolitis syndrome (FPIES). The APT involves placement of food in a Finn chamber (metal cap) left on the skin for 48 hours and evaluated for rash in the subsequent days after removal.
STUDY POPULATION. Nineteen patients aged 5 to 30 months who had suspected FPIES on the basis of clinical history.
METHODS. The infants underwent APT to the suspected foods. After APT was performed, the subjects underwent OFC to determine if FPIES was present. The results of APT and OFC were compared and used to calculate sensitivity and specificity of the APT.
RESULTS. APT predicted the results of OFCs in 28 of 33 instances. There were 16 cases of FPIES confirmed by OFCs. In all 16 cases of FPIES, the APT result was positive to the suspected food. However, the APT was positive in 5 instances in which the OFC result was negative. All 12 patients with a negative APT result had a negative OFC result to the suspected food.
CONCLUSIONS. APT seems to be a promising diagnostic tool for the diagnosis of FPIES.
REVIEWER COMMENTS. FPIES is a non–immunoglobulin E (IgE)-mediated food allergy in which affected infants develop gastrointestinal symptoms hours after ingestion of the offending food. Current allergy skin and serum tests are not useful for diagnosing this disorder, because they test for food-specific IgE levels that are often negative in FPIES. A diagnostic OFC is the gold standard. The role for APT in diagnosing other non–IgE-mediated food hypersensitivities has been investigated. The results of this study suggest that APT may have some utility in guiding the diagnosis and management of FPIES.
- Copyright © 2007 by the American Academy of Pediatrics