RELIABILITY OF PUMPKIN-SPECIFIC IGE AND TOTAL IGE PRIOR TO ORAL FOOD CHALLENGE

Abstract

<h3>Introduction</h3> Nine major food allergens account for >90% of all food-allergies and as such, research into other food allergies is relatively sparse. True allergy to pumpkin is rarely reported in the literature, as is data regarding the reliability of total and specific IgE testing prior to oral food challenge (OFC). <h3>Methods</h3> Retrospective chart review was performed on three patients with reported possible pumpkin allergy who underwent pumpkin-specific IgE testing prior to pumpkin OFC. Their charts were reviewed for demographic data, pumpkin-specific IgE testing, total IgE testing, other food allergies, atopic conditions, and pumpkin OFC results. <h3>Results</h3> All three patients were found to have a history of atopic conditions and other food allergies. Symptoms after purported pumpkin exposure included shortness of breath, rash, throat tightening/itching, coughing, and emesis. Average total IgE=1101.33 (SD:892.42 N=3) and pumpkin-specific IgE=2.66 (SD:4.19 N=3). Two of the patients underwent OFC to pumpkin seed and the third underwent OFC to pumpkin puree, with all three patients passing their respective OFCs. For all three patients, the value of their pumpkin-specific IgE was <1% that of their total IgE with an average of 0.16% (SD:0.20). <h3>Conclusion</h3> This study finds that elevated total IgE and/or pumpkin-specific IgE are not reliable pre-test predictors for OFC failure. However, the results do suggest that a low pumpkin-specific IgE to total IgE ratio may be helpful in predicting successful OFC.