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Skin prick test or serum IgE test alone may be insufficient for identifying allergens

There is a significant discordance between skin prick testing and allergen-specific serum immunoglobulin E test results in children aged younger than 4 years, results from a recent study in Annals of Allergy, Asthma, and Immunology suggest.

“Although the clinical relevance of low-level allergic sensitization in young children remains to be elucidated, our data indicate that both skin and serum testing are contributory in comprehensively diagnosing allergic sensitizations in inner city, highly atopic children,” study researchers said.

Researchers compared the yield of skin prick tests with that of allergen-specific serum IgE to assess the efficacy of both methods as identifiers of aeroallergen sensitization in atopic children younger than 4 years. A group of 40 inner-city atopic children was recruited for the study. Each child was aged 18 to 48 months and had a family history of asthma and/or eczema, as well as recurrent wheezing. Children underwent skin prick tests to determine positive allergies, as well as serum IgE tests performed within the next 4 weeks. Results showed that one or more allergen sensitizations would have been missed in 80% of children if only skin prick tests had been performed. In 38% of children, one or more allergen sensitizations would have been missed if only serum IgE testing had been performed. The agreement between the skin prick test and the serum IgE test was fair for most allergens, as was the correlation between serum IgE levels and skin prick test grade, according to the researchers.

“It may be necessary to perform specific [serum] IgE testing in addition to a skin prick test when accurate diagnosis of aeroallergen sensitization is required to define an appropriate intervention, such as environmental remediation, or even immunotherapy,” researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.