The relationship of allergen-specific IgE levels and oral food challenge outcome

Tamara T. Perry, Elizabeth C. Matsui, Mary Kay Conover-Walker, Robert A. Wood

Research output: Contribution to journalArticlepeer-review

269 Scopus citations


Background Oral food challenges remain the gold standard for the diagnosis of food allergy. However, clear clinical and laboratory guidelines have not been firmly established to determine when oral challenges should be performed. Objective We sought to determine the value of food-specific IgE levels in predicting challenge outcome. Methods A retrospective chart review of 604 food challenges in 391 children was performed. All children had food-specific IgE levels measured by means of CAP-RAST before challenge. Data were analyzed to determine the relationship between food-specific IgE levels and challenge outcome, as well as the relationship between other clinical parameters and challenge outcome. Results Forty-five percent of milk challenges were passed compared with 57% for egg, 59% for peanut, 67% for wheat, and 72% for soy. Specific IgE levels were higher among patients who failed challenges than among those who passed (P ≤ .03 for each food). When seeking a specific IgE level at which a 50% pass rate could be expected, a cutoff level of 2 kUA/L was determined for milk, egg, and peanut. Data were less clear for wheat and soy. Coexistent eczema or asthma was associated with failed egg challenges, but other atopic disease was otherwise not associated with challenge outcome. Conclusions Allergen-specific IgE concentrations to milk, egg, and peanut and, to a lesser extent, wheat and soy serve as useful predictors of challenge outcome and should be considered when selecting patients for oral challenge to these foods.

Original languageEnglish (US)
Pages (from-to)144-149
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Issue number1
StatePublished - Jul 2004


  • Food allergy
  • PPV
  • Positive predictive value
  • food-specific IgE concentrations
  • oral food challenges

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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