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. 2024 Sep;16(5):555-561.
doi: 10.4168/aair.2024.16.5.555.

Diagnostic Decision Point for IgE-Mediated Wheat Allergy in Children

Yoonha Hwang  1 , Jihyun Kim  2 , Kangmo Ahn  2 , Kyunguk Jeong  3 , Sooyoung Lee  3 , Soo-Jong Hong  4 , You Hoon Jeon  5 , Yoon Hee Kim  6 , Meeyong Shin  7 , Tae Won Song  8 , Minyoung Jung  9 , Minji Kim  10 , Taek Ki Min  11 , Ji Young Lee  12 , Min Jung Kim  13 , Yong Ju Lee  13 , Jeongmin Lee  14 , Young A Park  15 , Gwang Cheon Jang  16 , Young Min Ahn  17 , So-Yeon Lee  18 , Jeong Hee Kim  19 ; Food Allergy and Atopic Dermatitis (FAAD) study Group in the Korean Academy of Pediatric Allergy and Respiratory Disease
Affiliations

Diagnostic Decision Point for IgE-Mediated Wheat Allergy in Children

Yoonha Hwang et al. Allergy Asthma Immunol Res. 2024 Sep.

Abstract

The diagnostic decision point can help diagnose food allergies while reducing the need for oral food challenge (OFC) tests. We performed a multicenter survey of children aged 0-7 years from January 1, 2018 to March 31, 2022. A total of 231 children were recruited from 18 institutions. Wheat allergy (WA) or non-wheat allergy (NWA) was determined on the basis of OFC results and symptoms. There were no differences in age, sex, family history of allergy or allergic comorbidities between the WA and NWA groups. According to receiver operating characteristic analysis for wheat-specific immunoglobulin E (IgE), the optimal cutoff value, positive decision point, and negative decision point were 10.2, 33.5, and 0.41 kU/L, respectively. For the ω-5 gliadin-specific IgE, their values were 0.69, 3.88, and 0.01 kU/L, respectively. This new diagnostic decision point may be used to diagnose WA in Korean children.

Keywords: Demographic; diagnosis; food allergy; ingestion; specific IgE; wheat.

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Fig. 1
Fig. 1. Comparison of wheat and ω-5 gliadin sIgE levels between the WA and NWA groups. The median wheat sIgE levels were 12.35 and 2.02 kU/L for the WA and NWA groups, respectively, and the median ω-5 gliadin sIgE levels were 1.68 and 0.34 kU/L, respectively. All data showed statistically significant differences (P < 0.001).
sIgE, specific immunoglobulin E; WA, wheat allergy; NWA, non-wheat allergy.
Fig. 2
Fig. 2. ROC curve. (A) ROC curve for wheat-sIgE and DDPs. (B) ROC curve for ω-5 gliadin-sIgE and DDPs.
ROC, receiver operating characteristic; sIgE, specific immunoglobulin E; DDP, diagnostic decision point; DP, decision point; AUC, areas under the curve.
Fig. 3
Fig. 3. ROC curve for wheat-sIgE and diagnostic decision points under the age of 1.
ROC, receiver operating characteristic; sIgE, specific immunoglobulin E; AUC, areas under the curve; DDP, diagnostic decision point; DP, decision point.
See this image and copyright information in PMC

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