PMID- 18588556
OWN - NLM
STAT- MEDLINE
DCOM- 20080730
LR  - 20151119
IS  - 1398-9995 (Electronic)
IS  - 0105-4538 (Linking)
VI  - 63
IP  - 7
DP  - 2008 Jul
TI  - Prediction of challenge test results by flour-specific IgE and skin prick test in 
      symptomatic bakers.
PG  - 897-902
LID - 10.1111/j.1398-9995.2008.01646.x [doi]
AB  - BACKGROUND: Wheat and rye flours are among the most important allergens causing 
      occupational asthma. Usually, the diagnosis of baker's asthma is based on 
      inhalation challenge tests with flours. AIMS OF THE STUDY: To evaluate the 
      relevance of flour-specific serum immunoglobulin E (IgE) and skin prick test 
      (SPT) in the diagnosis of baker's asthma and to define flour-specific IgE 
      concentrations and wheal sizes that allow a prediction of the outcome of 
      challenge testing. METHODS: Bronchial and nasal challenge tests with wheat (rye) 
      flour were performed in 71 (95) symptomatic bakers. Determinations of 
      flour-specific IgE as well as SPTs were performed in all subjects. Analyses 
      included the calculation of sensitivity, specificity, positive (PPV) and negative 
      predictive values (NPV) at different IgE concentrations and different wheal 
      sizes, and receiver-operating characteristics (ROC) plots with the challenge 
      result as gold standard. RESULTS: Thirty-seven bakers were positive in the 
      challenge with wheat flour, while 63 were positive with rye flour. Depending on 
      the flour-specific IgE concentrations (wheal size), PPV was 74-100% (74-100%) for 
      wheat and 82-100% (91-100%) for rye flour, respectively. The minimal cut-off 
      values with a PPV of 100% were 2.32 kU/l (5.0 mm) for wheat flour and 9.64 kU/l 
      (4.5 mm) for rye flour. The shapes of the ROC plots were similar for wheat and 
      rye flour. CONCLUSION: High concentrations of flour-specific IgE and clear SPT 
      results in symptomatic bakers are good predictors for a positive challenge test. 
      Challenge tests with flours may be avoided in strongly sensitized bakers.
FAU - van Kampen, V
AU  - van Kampen V
AD  - BGFA - Research Institute of Occupational Medicine, German Social Accident 
      Insurance, Ruhr-University Bochum, Germany.
FAU - Rabstein, S
AU  - Rabstein S
FAU - Sander, I
AU  - Sander I
FAU - Merget, R
AU  - Merget R
FAU - Bruning, T
AU  - Bruning T
FAU - Broding, H C
AU  - Broding HC
FAU - Keller, C
AU  - Keller C
FAU - Musken, H
AU  - Musken H
FAU - Overlack, A
AU  - Overlack A
FAU - Schultze-Werninghaus, G
AU  - Schultze-Werninghaus G
FAU - Walusiak, J
AU  - Walusiak J
FAU - Raulf-Heimsoth, M
AU  - Raulf-Heimsoth M
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adult
MH  - Allergens/adverse effects
MH  - Asthma/diagnosis/immunology
MH  - Bronchial Provocation Tests
MH  - Female
MH  - Flour/*adverse effects
MH  - Food Handling
MH  - Humans
MH  - Immunoglobulin E/*immunology
MH  - Male
MH  - Middle Aged
MH  - Nasal Provocation Tests
MH  - Occupational Diseases/*diagnosis
MH  - *Occupational Exposure
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Secale/adverse effects
MH  - Skin Tests
MH  - Triticum/adverse effects
MH  - Wheat Hypersensitivity/*diagnosis/immunology
EDAT- 2008/07/01 09:00
MHDA- 2008/07/31 09:00
CRDT- 2008/07/01 09:00
PHST- 2008/07/01 09:00 [pubmed]
PHST- 2008/07/31 09:00 [medline]
PHST- 2008/07/01 09:00 [entrez]
AID - ALL1646 [pii]
AID - 10.1111/j.1398-9995.2008.01646.x [doi]
PST - ppublish
SO  - Allergy. 2008 Jul;63(7):897-902. doi: 10.1111/j.1398-9995.2008.01646.x.