When is skin testing for food allergens indicated in the evaluation of anaphylaxis?

Updated: May 16, 2018
  • Author: S Shahzad Mustafa, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

If the patient’s medical history and physical examination findings suggest a possible association with food ingestion, percutaneous (puncture) food allergen–specific skin tests and/or in vitro–specific IgE tests (eg, radioallergosorbent assay test [RAST] or ImmunoCAP IgE tests [Phadia AB; Uppsala, Sweden]) can be performed, with an understanding that both false-positive and false-negative results may occur. In the absence of a suggestive clinical history, the rate of false-positive results has been reported to be roughly 50% for both skin tests and in vitro–specific IgE tests. In vitro–specific IgE testing can have roughly a 95% positive predictive value if values are over certain cutoff levels, which vary with the individual food in question.


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