PMID- 18312533
OWN - NLM
STAT- MEDLINE
DCOM- 20090601
LR  - 20151119
IS  - 1399-3038 (Electronic)
IS  - 0905-6157 (Linking)
VI  - 19
IP  - 4
DP  - 2008 Jun
TI  - Paediatric allergy diagnosis in primary care is improved by in vitro 
      allergen-specific IgE testing.
PG  - 325-31
LID - 10.1111/j.1399-3038.2007.00651.x [doi]
AB  - Allergy testing is an important pre-requisite for both early identification of 
      infants at increased risk for later development of allergic diseases and for 
      specific allergy treatment including specific allergen avoidance measures, 
      pharmacotherapy and specific immunotherapy. The aim of this study was to 
      investigate the influence of in vitro allergen-specific immunoglobulin E (IgE) 
      testing on the primary care physician's diagnosis and clinical management of 
      children with symptoms of eczema, wheezing/asthma and rhinitis. The trial was a 
      prospective study performed at 14 paediatric primary care practices in Germany, 
      covering 380 children below 6 yr of age. For one group of children the physician 
      received the IgE test results as soon as possible and used them as an additional 
      tool when diagnosing and giving clinical management advice. For the other group 
      of children the IgE test results were not made available to the physician until 
      the children were brought to a second visit, about 7 wk later. When diagnosis was 
      made without access to allergen-specific IgE results, 8% of the children were 
      diagnosed as allergic, 6% as non-allergic and in 86% of the cases the physician 
      was uncertain. With access to allergen-specific IgE results the figures were 13%, 
      65% and 22%, respectively. Concerning clinical management advice no statistically 
      significant differences between the two study groups were observed. When 
      comparing the first and second visits of the patients coming for a second visit 
      advice to reduce aeroallergen exposure was given to 27% of the patients at visit 
      1 and to 36% of the patients at visit 2 (p = 0.002). The difference between the 
      first and second visits of the other clinical management advice studied did not 
      reach statistical significance. In this study the availability of IgE test 
      results to the primary care physician had an impact on the decision-making 
      process of the diagnosis but not on the pharmaceutical or avoidance advice given. 
      The reason why IgE test results were not fully exploited needs to be further 
      scrutinized.
FAU - Niggemann, Bodo
AU  - Niggemann B
AD  - Department of Pediatric Pneumology and Immunology, Children's Hospital Charite, 
      Berlin, Germany. bodo.niggemann@charite.de
FAU - Nilsson, Monika
AU  - Nilsson M
FAU - Friedrichs, Frank
AU  - Friedrichs F
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080227
PL  - England
TA  - Pediatr Allergy Immunol
JT  - Pediatric allergy and immunology : official publication of the European Society 
      of Pediatric Allergy and Immunology
JID - 9106718
RN  - 0 (Allergens)
RN  - 0 (Epitopes)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
CIN - Pediatr Allergy Immunol. 2008 Dec;19(8):777-8. PMID: 19076566
MH  - Allergens/immunology
MH  - Asthma/blood/*diagnosis/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Diagnostic Tests, Routine
MH  - Eczema/blood/*diagnosis/epidemiology
MH  - Epitopes
MH  - Female
MH  - Germany
MH  - Humans
MH  - Immunoglobulin E/*blood/immunology
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Primary Health Care
MH  - Rhinitis/blood/*diagnosis/epidemiology
EDAT- 2008/03/04 09:00
MHDA- 2009/06/02 09:00
CRDT- 2008/03/04 09:00
PHST- 2008/03/04 09:00 [pubmed]
PHST- 2009/06/02 09:00 [medline]
PHST- 2008/03/04 09:00 [entrez]
AID - PAI651 [pii]
AID - 10.1111/j.1399-3038.2007.00651.x [doi]
PST - ppublish
SO  - Pediatr Allergy Immunol. 2008 Jun;19(4):325-31. doi: 
      10.1111/j.1399-3038.2007.00651.x. Epub 2008 Feb 27.