Development of atopic disease during childhood and its prediction by Phadiatop Paediatric

Background Evaluating in vivo and/or in vitro tests for ‘early’ prediction of childhood allergy is of interest in paediatric allergology. Objective To determine whether the measurement of Phadiatop Paediatric (PP) during early childhood could be used to predict the development of atopic disease during the first 5 years of life among infants with a family history of atopic disease. Methods Phadiatop Paediatric was evaluated in 134 infants. The analysis was performed at 6 months, at 18 months and at 5 years of age and the numbers of available serum samples were 61, 85 and 134, respectively. The potential capacity of the test to predict the development of atopic disease was studied by relating the result of the test, a positive or a negative score, to the cumulated incidence of atopic diseases from birth to 18 months of age and from birth to 5 years of age. Results Three of four children with a positive PP at 6 months of age developed clinical signs/symptoms of atopic disease before 18 months and all four before 5 years of age. The predictive value of a positive test at 18 months for symptoms before 5 years of age was 80% (12/15). If the diagnostic criterion, instead of clinical signs/symptoms of atopic disease, was at least one positive skin-prick test to major food or inhalant allergens, the predictive value of a positive PP-test at 18 months decreased to 53% (8/ 15). Conclusion Although the presence of circulating IgE antibodies, as detected by Phadiatop Paediatric, can predict the development of atopic diseases during childhood, the usefulness of the test is limited by its low sensitivity (22-47%).