Sesame-Specific IgE Levels May Help Diagnose Allergies

Sesame allergy affects 17 percent of children with IgE-mediated food allergy

FRIDAY, Nov. 8, 2019 (HealthDay News) -- Sesame immunoglobulin E (IgE) levels may have diagnostic utility for sesame allergy, according to a letter to the editor published online Oct. 28 in Pediatric Allergy and Immunology.

Kristin Sokola, M.D., from the National Institutes of Health in Bethesda, Maryland, and colleagues examined the prevalence and manifestations of sesame allergy in a population of U.S. children with IgE-mediated food allergy in an effort to determine the utility of specific IgE (sIge) testing in predicting sesame allergy. Sensitization and clinical reactivity to sesame were assessed among 119 consecutive individuals (median age, 9.0 years; 61.3 percent male) with IgE-mediated food allergy enrolled in a Natural History of Food Allergy protocol at the National Institutes of Health. Oral food challenges (OFCs) were offered to all participants.

The researchers found that 91 percent of participants were sensitized to sesame, 12.6 percent were confirmed sesame-allergic, and 61.3 percent were sesame-tolerant. Sesame allergy status could not be determined for 26.1 percent of individuals, most of whom were avoiding it as a result of previous positive sIgE testing. Between those allergic and those tolerant to sesame, there were no statistically significant differences in age, gender, ethnicity, allergic comorbidities, total reported food allergies (excluding sesame), or total IgE levels. Among the 88 participants with confirmed sesame-allergic status, the sesame-specific IgE threshold that maximized the sum of estimated sensitivity and specificity was 11.6 kUa/L, with a sensitivity of 0.93 and a specificity of 0.85. Dividing sesame IgE by total serum IgE did not improve the ability to predict allergy in this cohort. However, a model with total IgE and sesame sIgE provided statistically significant better prediction of sesame allergy than a model with sesame sIgE alone.

"Sesame allergy is common among children with IgE-mediated food allergy, and often co-occurs with peanut and tree nut sensitization and allergy," the authors write.

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