Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student research


Towards understanding the predictive capacity of Diallertest´┐Ż Wheat and Milk patches in children with and without Autistic Spectrum Disorder

by
Page Thody
Master of Science (Nutrition and Dietetics), University of Wollongong
Supervisors: Maria Andonopolous, Velencia Soutter, Robert Loblay, Anne Swain
October 2007

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Abstract

Introduction: Wheat and milk sensitivities are common in children and those with Autistic Spectrum Disorder (ASD) may be more susceptible than others. (Horvath K M.D. and Perman, J M.D.,2002, Wakefield AJ et al, 2002 ).Traditionally elimination diets followed by oral challenges are conducted to determine food intolerance. The Diallertest Atopy Patch Test is designed to register T-cell mediated late phase food sensitivity and is proposed as a alternate diagnostic measure.

Aim: To evaluate the validity of Diallertest wheat and milk patches as a determinant of wheat and milk intolerance in children.

Method: Diallertest wheat and milk atopy patches were tested on children aged one to thirteen years (N=123). Reactivity to APT was measured against milk and wheat oral challenge results previously conducted in a subgroup of the same children (N=31). Sensitivity, specificity, positive predictive value, negative predictive value and overall agreement of the patches were determined by statistical analysis.

Results: While some of our results showed similar trends to those of previous studies (Niggemann et al, 1999, Canani et al, 2007, Fogg et al, 2006) the predictive value as demonstrated by overall agreement was poor.

Conclusion: Notwithstanding its success in the literature, preliminary findings of this study suggest a limited predictive value for Diallertest wheat and milk patches in regard to wheat or milk reactivity from oral challenge. However, a limitation in this particular study is the interlude between the oral challenge and the patch testing, as changes in reactivity may have occurred during this time.

Although our study was flawed by factors relating to the comparative measure it seems evident that Diallertest patches measured heightened reactivity in over 50 % of participants. Although we cannot clarify the predictive capacity of Diallertest at present neither can we dismiss the potential value of this product.