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Guidelines on the Clinical Usefulness of Determination of Specific Immunoglobulin E to Foods


BE García,1 PM Gamboa,2 JA Asturias,3 M López-Hoyos,4 ML Sanz,5 on behalf of the Clinical Immunology Committee of the Spanish Society of Allergology and Clinical Immunology (MT Caballero, JM García, M Labrador, C Lahoz, N Longo Areso, J Martínez Quesada, L Mayorga, FJ Monteseirín)

1Hospital Virgen del Camino, Pamplona, Spain
2Hospital Basurto, Bilbao, Spain
3Bial-Arístegui, Bilbao, Spain
4Hospital de Valdecilla, Santander, Spain
5Clínica Universidad de Navarra, Collaborative Center of GA2LEN, Pamplona, Spain

J Investig Allergol Clin Immunol 2009; Vol. 19(6): 423-432



The diagnostic gold standard for food allergy is challenge with the culprit food, particularly in double-blind placebo-controlled challenge.
This approach involves risks and consumes both time and resources. A more efficient system would be desirable. The detection of serum specific immunoglobulin E (sIgE) against the culprit food enables us to establish sensitization, although this is not always accompanied by clinical reactivity. Age, symptoms (immediate/late reaction, local/systemic reaction), concomitant condition (eg, atopic dermatitis, pollinosis)
and selection sample criteria (eg, presence of symptoms related to ingestion, positive skin prick test result) can influence the detection and concentration of IgE against foods. We analyze the clinical usefulness of sIgE determination in light of studies in which oral food challenge is used as the diagnostic method. We review clinical usefulness at diagnosis and in the decision to reintroduce the food, as well as the
prognostic value of the determination of IgE to foods.

Key words: Specific IgE. Food allergy. Diagnosis. Prognosis.