Prick test accuracy for Der p components in pediatric rhinitis.

UNLABELLED: This study aimed to evaluate the accuracy of prick tests for Der p1, Der p2, and Der p23 in estimating specific IgE sensitization to these components in children with rhinitis. A retrospective cohort study was conducted in 125 children with rhinitis who had a positive prick test to Dermatophagoides pteronyssinus. We compared the number of children sensitized by prick test to Der p1, Der p2, and Der p23 with those sensitized by specific IgE (ImmunoCAP) for each component. We used Student's t-test and chi-squared tests for the analysis. We also evaluated the accuracy of the molecular prick tests for estimating specific IgE to the components using ROC curves. The percentage of children sensitized by the prick test differed from those sensitized by specific IgE for Der p1 and Der p2. For Der p1, the percentages were 62.4% vs. 78.9% (p = 0.03). For Der p2, the rates were 41.4% vs. 72.7% (p < 0.001). For Der p23, the difference was not significant (64.2% vs. 68.2%, p = NS). Positive prick tests showed high accuracy for estimating specific IgE sensitization to Der p1 (AUC: 0.88, PPV: 93.7%, p < 0.001), Der p2 (AUC: 0.78, PPV: 100%, p < 0.001), and Der p23 (AUC: 0.86, PPV: 92.3%, p < 0.001).

CONCLUSIONS

Prick tests are highly accurate for estimating specific IgE sensitization to Der p1, Der p2, and Der p23. When positive, they could guide specific immunotherapy in children without the need for additional laboratory tests.

WHAT IS KNOWN: • IgE Der p components are highly useful for diagnostic and prognostic evaluation. They also guide the indication for immunotherapy in children with rhinitis, with or without allergic asthma, sensitized to D. pteronyssinus.

WHAT IS NEW: • This study is the first to describe the profile of allergic sensitization to Der p components using a prick test in children with rhinitis sensitized to D. pteronyssinus. Additionally, we describe for the first time the high predictive value of having positive IgE to Der p components in children with rhinitis who show positive prick test results for Der p components.