Biomedical subjects

Petra E D Eysink

Publications and source records attributed to Petra E D Eysink.

3 recordsLinked to original sources

PubMed2005

Accuracy of specific IgE in the prediction of asthma: development of a scoring formula for general practice.

BACKGROUND: For the diagnosis of asthma in young children, GPs have to rely on history taking and physical examination, as spirometry is not possible. The additional diagnostic value of specific immunoglobulin E (IgE) to inhalent allergens remains unclear. AIM: To assess the predictive accuracy of specific IgE to cat, dog, and/or house dust mites in young children for the subsequent development of asthma at the age of 6 years. DESIGN OF STUDY: Prospective follow-up study. SETTING: Seventy-two general practices. METHOD: A total of 654 children, aged 1-4 years, visiting their GPs for persistent coughing (>/= 5 days), were tested for IgE antibodies by radio allergosorbent testing (RAST). Parents completed a questionnaire on potential risk indicators. Those children who showed an IgE-positive status (12.7%) and a random sample of those with an IgE-negative status (<0.5 U/ml) were followed up to the age of 6 years when the asthma status was established. The main outcome measure was asthma at the age of 6 years (combination of both symptoms and/or use of asthma medication, and impaired lung function). RESULTS: Addition of RAST results to a prediction model based on age, wheeze, and family history of pollen allergy increased the area under the receiver operating characteristic (ROC) curve from 0.76 to 0.87. Furthermore, RAST improved patient differentiation as indicated by a change in the range of asthma probabilities from 6-75% before the IgE test, to 1-95% after the IgE-test. CONCLUSION: Sensitisation to inhalant allergens in 1-4-year-olds, as shown by RAST, is a useful diagnostic indicator for the presence of asthma at the age of 6 years, even after a clinical history has been obtained. This model should preferably be validated in a new population before it can be applied in practice.

Allergens↗

PubMed2004

IgE testing in capillary blood.

Serologic IgE testing is generally performed using serum, obtained by venepuncture. We tested whether paper-absorbed and eluted capillary blood, obtained by a less invasive method (finger prick) could be used for allergy testing in young children. This was performed by comparative IgE testing, using paper-absorbed blood/serum and serum. Practical applicability of the procedure was tested by assaying paper-absorbed and eluted blood, obtained from 640 children with complaints of prolonged coughing, for IgE to airborne allergens. We found that IgE testing, using paper-absorbed/eluted material and serum yields virtually identical results (mean ratio for positive samples: 1.01, 95% confidence interval: 0.58-1.75). Blood spot testing revealed that sensitization to inhalant allergens is not uncommon in preschool children (13% positive radioallergosorbent test [RAST] tests), which means that this procedure is a useful method for assaying allergic sensitization in children.

Blood Specimen Collection↗

PubMed2004

Coughing in pre-school children in general practice: when are RAST's for inhalation allergy indicated?

To identify patterns of clinical history associated with extreme (high or low) probabilities of allergic sensitization in coughing children so as to restrict allergy testing to those with an intermediate probability of sensitization. A total of 752 children, aged 1-4, visiting their GPs for coughing (>or=5 days), were tested for IgE-antibodies to house dust mite, cat and dog [RadioAllergoSorbent Test (RAST)]. Parents completed a questionnaire on family history of atopy, breastfeeding, smoking, pets, and floor covering. Data of 640 children could be analyzed, 83 (13%) were IgE-positive. In a logistic regression analysis, a scoring formula for the prediction of being IgE-positive was constructed using variables from the patient's history. Significant contributors for sensitization were: age (3-4 yr), infantile eczema, positive family history of mite-allergy, sibling(s) with pollen-allergy, and smoking by parents. If only one of these characteristics is present, the probability of sensitization is < 25%. In such cases watchful waiting may be preferred over allergy testing. In other cases, a negative RAST may help to exclude sensitization, whereas a positive RAST helps to establish the diagnosis. Thus, acting on clinical history alone may save approximately 80% of RAST's. Patient history-derived information contributes to distinguishing children who are at low risk for sensitization to house dust mite, cat, and dog. The scoring formula may help GPs to identify children with a low probability of being sensitized. This may form the basis for watchful waiting. In others, allergy testing may be useful to gain more diagnostic certainty.

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