Value of the atopy patch test in the diagnosis of food allergy in children with gastrointestinal symptoms

Abstract

Background. In recent years, food allergy, especially in the child population, has become an increasing problem in developed societies. In the youngest children, it is a frequent cause of gastrointestinal disorders. The atopy patch test, applied from several years in clinical practice, is one of the methods used in allergology. Objectives. The objective of the work was an assessment of the diagnostic value of the atopy patch test in the diagnosis of allergy to cow's milk protein and to wheat proteins in children with gastrointestinal symptoms. Material and Methods. The study was comprised of 61 children (37 boys and 24 girls, aged 3 to 36 months, average age 13.5 months). Their medical history might have indicated a connection between the symptoms and ingested food. In all the children, an atopy patch test and a skin prick test with native food allergens were carried out. Table 1 presents the characteristics of the studied patients. Diagnosis of allergy to cow's milk protein and to wheat was verified in the open food challenge. Results. Sensitivity of APT for milk was 21%, specificity - 91%, PPV - 80%, NPV - 39% and for wheat - 67%, 100%, 100% and 77%, respectively (Table 4). For the skin prick test, sensitivity, specificity, PPV and NPV were 13%, 96%, 83% and 39% for milk and 22%, 80%, 50% and 53% for wheat. Conclusions. APT demonstrates high sensitivity and high specificity in the diagnosis of allergy to wheat in children with gastrointestinal symptoms. The sensitivity of ATP in the detection of allergy to cow's milk in children with gastrointestinal symptoms was low and therefore the diagnosis should be verified by challenge tests. © Copyright by Wroclaw Medical University.