TOPLINE:
Researchers have developed a scoring tool that predicts whether a child with a suspected food allergy really has one. The tool, known as the Naples Pediatric Food Allergy (NAPFA) score, incorporates factors such as age at symptom onset, prior atopic dermatitis, and allergies in first-degree family members.
METHODOLOGY:
- Researchers evaluated 627 pediatric participants with suspected food allergies (age, 0-14 years; 54.7% boys) from January to December 2023 to assess the accuracy of a clinical scoring system for predicting food allergies in children.
- Participants underwent food allergy screening tests, including skin prick tests, atopy patch tests, and measurement of food-specific serum immunoglobulin E levels, followed by a 4-week elimination diet.
- For children whose food allergy–related signs and symptoms disappeared during the elimination diet, a diagnostic oral food challenge (OFC) was performed.
- Researchers assessed two predictive models. One model (M1) incorporated symptoms following food ingestion, whereas the other version (M2) replaced that element with results from allergy screening tests.
TAKEAWAY:
- Among 368 patients who completed the elimination diet, 328 (89%) demonstrated positive results during the OFC, with cow’s milk identified as the most prevalent allergen (60.1%).
- Factors in the predictive models included sex; age at symptom onset; cesarean delivery; occurrence of atopic dermatitis before the onset of a possible food allergy; allergies in first-degree relatives; food-specific reactions; and skin, gastrointestinal, respiratory, and systemic symptoms.
- Both predictive models exhibited a good ability to identify patients with and without food allergy, with M1 achieving a c-statistic of 0.915 (95% CI, 0.895-0.937) and M2 attaining a c-statistic of 0.977 (95% CI, 0.969-0.992).
IN PRACTICE:
“The NAPFA score is the first scoring system to incorporate anamnestic and clinical features that facilitate the diagnostic approach of pediatric food allergy,” the authors wrote. “Notably, its accuracy and feasibility even without allergy test results enable its application in various healthcare settings, with the potential to reduce healthcare costs and wait times, once externally validated.”
SOURCE:
Roberto Berni Canani, MD, PhD, with the University of Naples Federico II in Naples, Italy, was the corresponding author of the study, which was published online on March 31 in Pediatric Allergy and Immunology.
LIMITATIONS:
The study focused on White participants from southern Europe and only included children younger than 14 years.
DISCLOSURES:
The study was funded by the Italian Ministry of Education, Universities and Research and the Italian Ministry of Health. The authors reported having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
