Lisätietoa aiheesta

IgE-vasta-aineiden raja-arvot ja tulkinta

Lisätietoa aiheesta
9.6.2025
Varpu Elenius, Kati Palosuo ja Peter Csonka

Taulukossa «IgE-vasta-aineiden raja-arvoja»1 esitetään tärkeimpien stabiilien ruoka-allergeenien varastoproteiinien allergiaoireita ennustavat raja-arvot 95 %:n tarkkuudella (raja-arvoa suurempi tulos viittaa 95 %:n todennäköisyydellä ruoka-allergiaan). Raja-arvot eivät ole tarkkoja, ja raja-arvoa pienempi tulos ei sulje pois ruoka-allergian mahdollisuutta. Mikäli IgE-arvo on negatiivinen (alle 0,35), ruoka-allergia on erittäin epätodennäköinen.

Taulukko 1. IgE-vasta-aineiden raja-arvoja
Kansainvälinen aineisto
Vaihteluväli (kypsennetty)		Suomalainen aineisto
MAITO
SPT > mm6–8 «Cuomo B, Indirli GC, Bianchi A, ym. Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow's milk according to age: a systematic review. Ital J Pediatr 2017;43(1):93 »16–8 «Saarinen KM, Suomalainen H, Savilahti E. Diagnostic value of skin-prick and patch tests and serum eosinophil cationic protein and cow's milk-specific IgE in infants with cow's milk allergy. Clin Exp A»2Alle 2-vuotiaiden raja-arvo on pienempi
maito-IgE > kU/l5–20 «Cuomo B, Indirli GC, Bianchi A, ym. Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow's milk according to age: a systematic review. Ital J Pediatr 2017;43(1):93 »1, «Caubet JC, Nowak-Węgrzyn A, Moshier E, ym. Utility of casein-specific IgE levels in predicting reactivity to baked milk. J Allergy Clin Immunol 2013;131(1):222-4.e1-4 »3, «Thorpe M, Movérare R, Fischer C, ym. History and Utility of Specific IgE Cutoff Levels: What is the Relevance for Allergy Diagnosis? J Allergy Clin Immunol Pract 2023;11(10):3021-3029 »46,3–13,9 «Nieminen O, Palosuo K, Kukkonen K, ym. Molecular allergy diagnostics in predicting oral cow's milk challenge outcome in Finnish children. Allergy Asthma Proc 2023;44(1):71-77 »5Alle 2-vuotiaiden raja-arvo on pienempi
Bos d 8 (kaseiini) > kU/l1–5 (20) «Caubet JC, Nowak-Węgrzyn A, Moshier E, ym. Utility of casein-specific IgE levels in predicting reactivity to baked milk. J Allergy Clin Immunol 2013;131(1):222-4.e1-4 »3, «Ayats-Vidal R, Valdesoiro-Navarrete L, García-González M, ym. Predictors of a positive oral food challenge to cow's milk in children sensitized to cow's milk. Allergol Immunopathol (Madr) 2020;48(6):5»6, «van der Gugten AC, den Otter M, Meijer Y, ym. Usefulness of specific IgE levels in predicting cow's milk allergy. J Allergy Clin Immunol 2008;121(2):531-3 »72,6–16,5 «Nieminen O, Palosuo K, Kukkonen K, ym. Molecular allergy diagnostics in predicting oral cow's milk challenge outcome in Finnish children. Allergy Asthma Proc 2023;44(1):71-77 »5Alle 2-vuotiaiden raja-arvo on pienempi
KANANMUNA
SPT > mm4–10 «Calvani M, Arasi S, Bianchi A, ym. Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review. Pediatr Allergy Immunol 2015;26(6):509-21 »8 Alle 2-vuotiaiden raja-arvo on pienempi
kananmuna-IgE > kU/l2–7 «Calvani M, Arasi S, Bianchi A, ym. Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review. Pediatr Allergy Immunol 2015;26(6):509-21 »8, «Sato S, Ogura K, Takahashi K, ym. Usefulness of antigen-specific IgE probability curves derived from the 3gAllergy assay in diagnosing egg, cow's milk, and wheat allergies. Allergol Int 2017;66(2):296»9, «Furuya K, Nagao M, Sato Y, ym. Predictive values of egg-specific IgE by two commonly used assay systems for the diagnosis of egg allergy in young children: a prospective multicenter study. Allergy 201»1013 «Palosuo K, Kukkonen AK, Pelkonen AS, ym. Gal d 1-specific IgE predicts allergy to heated egg in Finnish children. Pediatr Allergy Immunol 2018;29(6):637-643 »11Alle 2-vuotiaiden raja-arvo on pienempi
Gal d 1 (ovomukoidi) > kU/l5,7–6,1 (27) «Furuya K, Nagao M, Sato Y, ym. Predictive values of egg-specific IgE by two commonly used assay systems for the diagnosis of egg allergy in young children: a prospective multicenter study. Allergy 201»10, «De Boer R, Cartledge N, Lazenby S, ym. Specific IgE as the best predictor of the outcome of challenges to baked milk and baked egg. J Allergy Clin Immunol Pract 2020;8(4):1459-1461.e5 »123,7 «Palosuo K, Kukkonen AK, Pelkonen AS, ym. Gal d 1-specific IgE predicts allergy to heated egg in Finnish children. Pediatr Allergy Immunol 2018;29(6):637-643 »11Alle 2-vuotiaiden raja-arvo on pienempi
VEHNÄ
SPT > mm
vehnä-IgE > kU/l70 «Nilsson N, Sjölander S, Baar A, ym. Wheat allergy in children evaluated with challenge and IgE antibodies to wheat components. Pediatr Allergy Immunol 2015;26(2):119-25 »13
Tri a 19, omega-5-gliadiini0,4–4 «Nilsson N, Sjölander S, Baar A, ym. Wheat allergy in children evaluated with challenge and IgE antibodies to wheat components. Pediatr Allergy Immunol 2015;26(2):119-25 »13, «Ebisawa M, Shibata R, Sato S, ym. Clinical utility of IgE antibodies to ω-5 gliadin in the diagnosis of wheat allergy: a pediatric multicenter challenge study. Int Arch Allergy Immunol 2012;158(1):71-»14, «Ricci G, Andreozzi L, Cipriani F, ym. Wheat Allergy in Children: A Comprehensive Update. Medicina (Kaunas) 2019;55(7): »15, «Shibata R, Nishima S, Tanaka A, ym. Usefulness of specific IgE antibodies to ω-5 gliadin in the diagnosis and follow-up of Japanese children with wheat allergy. Ann Allergy Asthma Immunol 2011;107(4):»16
MAAPÄHKINÄ
SPT > mm8 «Greenhawt M, Shaker M, Wang J, ym. Peanut allergy diagnosis: A 2020 practice parameter update, systematic review, and GRADE analysis. J Allergy Clin Immunol 2020;146(6):1302-1334 »17
maapähkinä-IgE > kU/l50 «Greenhawt M, Shaker M, Wang J, ym. Peanut allergy diagnosis: A 2020 practice parameter update, systematic review, and GRADE analysis. J Allergy Clin Immunol 2020;146(6):1302-1334 »17, «van Erp FC, Knol EF, Pontoppidan B, ym. The IgE and basophil responses to Ara h 2 and Ara h 6 are good predictors of peanut allergy in children. J Allergy Clin Immunol 2017;139(1):358-360.e8 »18
Ara h 2 > kU/l2 «Greenhawt M, Shaker M, Wang J, ym. Peanut allergy diagnosis: A 2020 practice parameter update, systematic review, and GRADE analysis. J Allergy Clin Immunol 2020;146(6):1302-1334 »171,8 «Kukkonen AK, Pelkonen AS, Mäkinen-Kiljunen S, ym. Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double-blind placebo-controlled study. Allergy 2015;70(10):1239-45 »19
Ara h 6 > kU/l0,3–1,0 «Flores Kim J, McCleary N, Nwaru BI, ym. Diagnostic accuracy, risk assessment, and cost-effectiveness of component-resolved diagnostics for food allergy: A systematic review. Allergy 2018;73(8):1609-16»200,8 «Kukkonen AK, Pelkonen AS, Mäkinen-Kiljunen S, ym. Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double-blind placebo-controlled study. Allergy 2015;70(10):1239-45 »19
CASHEW
SPT > mm3–12 «van der Valk JP, Dubois AE, Gerth van Wijk R, ym. Systematic review on cashew nut allergy. Allergy 2014;69(6):692-8 »219–11 «Röntynen P, Kukkonen K, Savinko T, ym. Optimizing tools for evaluating challenge outcomes in children with cashew nut allergy. Ann Allergy Asthma Immunol 2022;128(3):270-278 »22
cashew-IgE > kU/l5–10 «van der Valk JP, Dubois AE, Gerth van Wijk R, ym. Systematic review on cashew nut allergy. Allergy 2014;69(6):692-8 »21, «Lange L, Lasota L, Finger A, ym. Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children. Allergy 2017;72(4):598-603 »234,5–6,5 «Röntynen P, Kukkonen K, Savinko T, ym. Optimizing tools for evaluating challenge outcomes in children with cashew nut allergy. Ann Allergy Asthma Immunol 2022;128(3):270-278 »22
Ana o 3 > kU/l0,6–2,2 «van der Valk JP, Dubois AE, Gerth van Wijk R, ym. Systematic review on cashew nut allergy. Allergy 2014;69(6):692-8 »21, «Lange L, Lasota L, Finger A, ym. Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children. Allergy 2017;72(4):598-603 »23, «Dang TD, Peters R, Neeland MR, ym. Ana o 3 sIgE testing increases the accuracy of cashew allergy diagnosis using a two-step model. Pediatr Allergy Immunol 2022;33(1):e13705 »24, «van der Valk JP, Gerth van Wijk R, Vergouwe Y, ym. sIgE Ana o 1, 2 and 3 accurately distinguish tolerant from allergic children sensitized to cashew nuts. Clin Exp Allergy 2017;47(1):113-120 »25, «Savvatianos S, Konstantinopoulos AP, Borgå Å, ym. Sensitization to cashew nut 2S albumin, Ana o 3, is highly predictive of cashew and pistachio allergy in Greek children. J Allergy Clin Immunol 2015;1»261,0 «Röntynen P, Kukkonen K, Savinko T, ym. Optimizing tools for evaluating challenge outcomes in children with cashew nut allergy. Ann Allergy Asthma Immunol 2022;128(3):270-278 »22
HASSEL
Hassel-IgE > kU/l
Cor a 9 > kU/l1–2 «Nilsson C, Berthold M, Mascialino B, ym. Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta-analysis. Pediatr Allergy Immunol 2020;31(2):186-196 »270,64 «Uotila R, Röntynen P, Pelkonen AS, ym. For hazelnut allergy, component testing of Cor a 9 and Cor a 14 is relevant also in birch-endemic areas. Allergy 2020;75(11):2977-2980 »28
Cor a 14 > kU/l0,7–1 «Nilsson C, Berthold M, Mascialino B, ym. Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta-analysis. Pediatr Allergy Immunol 2020;31(2):186-196 »272 «Uotila R, Röntynen P, Pelkonen AS, ym. For hazelnut allergy, component testing of Cor a 9 and Cor a 14 is relevant also in birch-endemic areas. Allergy 2020;75(11):2977-2980 »28
SAKSANPÄHKINÄ
SPT > mm8–10 «Elizur A, Appel MY, Nachshon L, ym. Clinical and Molecular Characterization of Walnut and Pecan Allergy (NUT CRACKER Study). J Allergy Clin Immunol Pract 2020;8(1):157-165.e2 »29, «Ballmer-Weber BK, Lidholm J, Lange L, ym. Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions. J Allergy Clin Immunol Pract 2019;7(5»30
saksanpähkinä-IgE > kU/l6,5 «Elizur A, Appel MY, Nachshon L, ym. Clinical and Molecular Characterization of Walnut and Pecan Allergy (NUT CRACKER Study). J Allergy Clin Immunol Pract 2020;8(1):157-165.e2 »29, «Ballmer-Weber BK, Lidholm J, Lange L, ym. Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions. J Allergy Clin Immunol Pract 2019;7(5»30
Jug r 1 > kU/l 0,9 «Elizur A, Appel MY, Nachshon L, ym. Clinical and Molecular Characterization of Walnut and Pecan Allergy (NUT CRACKER Study). J Allergy Clin Immunol Pract 2020;8(1):157-165.e2 »29, «Ballmer-Weber BK, Lidholm J, Lange L, ym. Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions. J Allergy Clin Immunol Pract 2019;7(5»30
Jug r 4 > kU/l0,9 «Elizur A, Appel MY, Nachshon L, ym. Clinical and Molecular Characterization of Walnut and Pecan Allergy (NUT CRACKER Study). J Allergy Clin Immunol Pract 2020;8(1):157-165.e2 »29, «Ballmer-Weber BK, Lidholm J, Lange L, ym. Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions. J Allergy Clin Immunol Pract 2019;7(5»30

Pähkinät

Kananmuna

Vehnä

Soija

  • Jos soijan sIgE on alle 0,35 kU/l, välittömän allergisen reaktion todennäköisyys on hyvin pieni. Tällöin potilasta voi ohjeistaa kokeilemaan soijatuotteita kotona. (Epäselvissä tapauksissa sietokyky voidaan varmistaa valvotulla altistuskokeella.)
  • Suurentunut soijan sIgE-arvo ei aina liity todelliseen soija-allergiaan. Koko allergeenilähteeseen liittyvä soija-IgE-tutkimus ei kykene erottamaan tarkemmin, mille yksittäiselle allergeenille potilas on herkistynyt. Ristiallergia siitepölyjen kanssa voi myös suurentaa soija IgE-pitoisuuksia yli viitealueen ylärajan. Lehtipuille herkistyneistä yli 70 %:lla todetaan vasta-aineita myös soijan Gly m 4 -proteiinille. Monilla lehtipuille herkistyneillä suurentunutnut soija-IgE tuleekin yllätyksenä tai sivulöydöksenä. Noin 10 % potilaista saattaa saada täysin kypsentämättömistä soijatuotteista (esim. soijajuoma) myös voimakkaita suun ja nielun oireita. Heillä IgE-vasta-ainepitoisuus koivulle on yleensä huomattavan suuri.
  • Molekyyliallergologian avulla saadaan tarkempi kuva herkistymisprofiilista ja vaikeiden reaktioiden riskistä. Jos IgE-välitteistä herkistymistä havaitaan vain Gly m 4 -proteiinia kohtaan ja muut soijan komponentit ovat alle viitearvon alarajan, kyse on lehtipuuallergiasta, ei varsinaisesta soija-allergiasta. Mikäli havaitaan voimakasta herkistymistä soijan vakaisiin allergeeneihin, Gly m 5 tai -6, diagnoosin varmistamiseksi suositellaan valvottua soija-altistusta.

Maito

Kirjallisuutta

  1. Cuomo B, Indirli GC, Bianchi A, ym. Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow's milk according to age: a systematic review. Ital J Pediatr 2017;43(1):93 «PMID: 29025431»PubMed
  2. Saarinen KM, Suomalainen H, Savilahti E. Diagnostic value of skin-prick and patch tests and serum eosinophil cationic protein and cow's milk-specific IgE in infants with cow's milk allergy. Clin Exp Allergy 2001;31(3):423-9 «PMID: 11260154»PubMed
  3. Caubet JC, Nowak-Węgrzyn A, Moshier E, ym. Utility of casein-specific IgE levels in predicting reactivity to baked milk. J Allergy Clin Immunol 2013;131(1):222-4.e1-4 «PMID: 22921870»PubMed
  4. Thorpe M, Movérare R, Fischer C, ym. History and Utility of Specific IgE Cutoff Levels: What is the Relevance for Allergy Diagnosis? J Allergy Clin Immunol Pract 2023;11(10):3021-3029 «PMID: 37245730»PubMed
  5. Nieminen O, Palosuo K, Kukkonen K, ym. Molecular allergy diagnostics in predicting oral cow's milk challenge outcome in Finnish children. Allergy Asthma Proc 2023;44(1):71-77 «PMID: 36400429»PubMed
  6. Ayats-Vidal R, Valdesoiro-Navarrete L, García-González M, ym. Predictors of a positive oral food challenge to cow's milk in children sensitized to cow's milk. Allergol Immunopathol (Madr) 2020;48(6):568-575 «PMID: 32402626»PubMed
  7. van der Gugten AC, den Otter M, Meijer Y, ym. Usefulness of specific IgE levels in predicting cow's milk allergy. J Allergy Clin Immunol 2008;121(2):531-3 «PMID: 18155280»PubMed
  8. Calvani M, Arasi S, Bianchi A, ym. Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review. Pediatr Allergy Immunol 2015;26(6):509-21 «PMID: 26102461»PubMed
  9. Sato S, Ogura K, Takahashi K, ym. Usefulness of antigen-specific IgE probability curves derived from the 3gAllergy assay in diagnosing egg, cow's milk, and wheat allergies. Allergol Int 2017;66(2):296-301 «PMID: 27523600»PubMed
  10. Furuya K, Nagao M, Sato Y, ym. Predictive values of egg-specific IgE by two commonly used assay systems for the diagnosis of egg allergy in young children: a prospective multicenter study. Allergy 2016;71(10):1435-43 «PMID: 27061295»PubMed
  11. Palosuo K, Kukkonen AK, Pelkonen AS, ym. Gal d 1-specific IgE predicts allergy to heated egg in Finnish children. Pediatr Allergy Immunol 2018;29(6):637-643 «PMID: 29974523»PubMed
  12. De Boer R, Cartledge N, Lazenby S, ym. Specific IgE as the best predictor of the outcome of challenges to baked milk and baked egg. J Allergy Clin Immunol Pract 2020;8(4):1459-1461.e5 «PMID: 31726233»PubMed
  13. Nilsson N, Sjölander S, Baar A, ym. Wheat allergy in children evaluated with challenge and IgE antibodies to wheat components. Pediatr Allergy Immunol 2015;26(2):119-25 «PMID: 25601168»PubMed
  14. Ebisawa M, Shibata R, Sato S, ym. Clinical utility of IgE antibodies to ω-5 gliadin in the diagnosis of wheat allergy: a pediatric multicenter challenge study. Int Arch Allergy Immunol 2012;158(1):71-6 «PMID: 22212744»PubMed
  15. Ricci G, Andreozzi L, Cipriani F, ym. Wheat Allergy in Children: A Comprehensive Update. Medicina (Kaunas) 2019;55(7): «PMID: 31340608»PubMed
  16. Shibata R, Nishima S, Tanaka A, ym. Usefulness of specific IgE antibodies to ω-5 gliadin in the diagnosis and follow-up of Japanese children with wheat allergy. Ann Allergy Asthma Immunol 2011;107(4):337-43 «PMID: 21962094»PubMed
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  18. van Erp FC, Knol EF, Pontoppidan B, ym. The IgE and basophil responses to Ara h 2 and Ara h 6 are good predictors of peanut allergy in children. J Allergy Clin Immunol 2017;139(1):358-360.e8 «PMID: 27516216»PubMed
  19. Kukkonen AK, Pelkonen AS, Mäkinen-Kiljunen S, ym. Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double-blind placebo-controlled study. Allergy 2015;70(10):1239-45 «PMID: 26095653»PubMed
  20. Flores Kim J, McCleary N, Nwaru BI, ym. Diagnostic accuracy, risk assessment, and cost-effectiveness of component-resolved diagnostics for food allergy: A systematic review. Allergy 2018;73(8):1609-1621 «PMID: 29319184»PubMed
  21. van der Valk JP, Dubois AE, Gerth van Wijk R, ym. Systematic review on cashew nut allergy. Allergy 2014;69(6):692-8 «PMID: 24734868»PubMed
  22. Röntynen P, Kukkonen K, Savinko T, ym. Optimizing tools for evaluating challenge outcomes in children with cashew nut allergy. Ann Allergy Asthma Immunol 2022;128(3):270-278 «PMID: 34896310»PubMed
  23. Lange L, Lasota L, Finger A, ym. Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children. Allergy 2017;72(4):598-603 «PMID: 27644013»PubMed
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  26. Savvatianos S, Konstantinopoulos AP, Borgå Å, ym. Sensitization to cashew nut 2S albumin, Ana o 3, is highly predictive of cashew and pistachio allergy in Greek children. J Allergy Clin Immunol 2015;136(1):192-4 «PMID: 25959668»PubMed
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  28. Uotila R, Röntynen P, Pelkonen AS, ym. For hazelnut allergy, component testing of Cor a 9 and Cor a 14 is relevant also in birch-endemic areas. Allergy 2020;75(11):2977-2980 «PMID: 32497265»PubMed
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  43. Nieminen O, Palosuo K, Kukkonen K, ym. Molecular allergy diagnostics in predicting oral cow's milk challenge outcome in Finnish children. Allergy Asthma Proc 2023;44(1):71-77 «PMID: 36400429»PubMed
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