In the older age group of NSC-737664 children, eczema and/or wheezing in combination with other allergic symptoms dominated (41%) and 48% were classified as atopic. Other allergy-like symptoms such as rhinitis, rhinoconjunctivitis, anaphylaxis, and gastrointestinal symptoms were registered in 31 (26%) children, out of whom 22 (71%) were older than 2 years (data not shown). Eighty-three of the children (68%) reported at least one first degree relative, with about the same proportion for the atopic as for the nonatopic children, 71% and 61%, respectively (data not shown). The diagnostic performance characteristics of Phadiatop Infant in this study population with a prevalence of 70% are presented in Table 2. The sensitivity calculated for the whole group of children was 98% (95% CI: 92�C100%) and the specificity 89% (95% CI: 74�C97%).
The PPV and NPV values were 95% (95% CI: 89�C99%) and 94% (95% CI: 80�C99%), respectively. The diagnostic performance of the test was found to be similar when the children were separated in the two age groups, below or above two years, but due to small numbers of children in the separated age groups, the calculated values are not presented. Table 2 Diagnostic performance characteristics of Phadiatop Infant. Data are given as number of children. 4. Discussion Symptoms of allergic disease in young children are generally unspecific and the diagnosis without objective tests could be an arbitrary process. The paediatric section of the European Academy of Allergy and Clinical Immunology has recently published a position paper with recommendations on allergy testing in children to improve the identification of allergy and quality of care [16].
An earlier published study has shown that 76 out of 147 children could not be classified as having an IgE-mediated disease or not, based on case history and physical examination alone. Allergen-specific IgE tests reduced this number to 8 [17]. Similar results were found in a recently published study, where measurements of IgE-antibodies, added to case history and physical examinations, highly improved the discrimination between IgE- and non-IgE-mediated diseases in young children [18]. The results from our study confirm these findings and suggest that Phadiatop Infant could be a useful tool for discrimination between atopy/non-atopy.
A positive Phadiatop Infant test should however be followed by allergen-specific antibody testing to a selected panel to identify the offending allergen(s) [19, 20]. The test seems to be at least as useful among the youngest children, below two years, as among children at 2�C4 years of age. The youngest child in the study was 6 months, which confirms findings from other publications that allergen-specific IgE-antibodies can be detected early in life [17, 18, 21]. These findings Anacetrapib support the value of testing children with allergy-like symptoms at an early age.