Heereveld, C.W.R. van (Chieljan) (2012) Specificiteit van laboratoriumonderzoek op pinda-allergie. thesis, Medicine.
Full text available on request.Abstract
Allergic reactions to peanut can range from mild (itching, swelling in the oral cavity) to severe (anaphylactic shock). (1) It is hard for general practitioners to correctly diagnose peanut allergy. The standard IgE blood test does not differentiate between mild and severe allergy and specificity of the test is so low that the Dutch society of general practitioners NHG advise against using it at all. (2) (3) (4) The standard IgE blood test is based on natural peanut extract. Nowadays it is possible to test for recombinant specific peanut components. Research has already shown this new test is more sensitive and specific. (3) In this study a comparison was made between sensitization to specific peanut allergens and clinical symptoms of peanut allergy in a group of 110 patients, who have been suspected of having peanut allergy by their general practitioners. The patients come from the north of the Netherlands, ages 2 to 66. The severity of their clinical symptoms was assessed using a questionnaire. rAra H2, rAra H8 and CCD were measured with ImmunoCAP (Phadia, Uppsala, Sweden) at LabNoord (Groningen, Netherlands). Patients were sorted in three groups based on the severity of their clinical symptoms. A Kruskal-Wallis test was used to compare the median IgE-values to the severity of the allergy. Peanut-extract and rAra H2 had significantly higher median values linked to a more severe reaction. Sensitivity and specificity of total peanut IgE and component IgE were calculated to predict the severity of clinical symptoms. Peanut extract was sensitive but not specific, rAra H2 was not sensitive yet more specific in correctly diagnosing peanut allergy. At a cut-off value with an optimal amount of correctly diagnosed patients showed peanut extract and rAra H8 were not very sensitive but highly specific in predicting the risk for severe reactions. Based on the results tests for specific peanut allergens are not necessarily better than the standard IgE blood test. The results suggest that by combining test on peanut extract and rAra H2 it may be possible to make peanut allergy IgE blood tests more specific and sensitive. Combining tests for peanut extract and rAra H8 could have a role in excluding risk for severe reactions. These are reasons for further research. NOTE: the numbers in the abstract refer to the reference list of the entire thesis
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Monchy, Prof. Dr. J.G.R. de Allergologie UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/964 |
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