D1.51 - Evaluation of the Correlation Between Skin Prick Test, Specific Immunoglobulin E Levels and Clinical Findings in Children with Cat Allergen Sensitization

Cat allergen sensitization is common in childhood; however, the relationship between immunological test results and clinically relevant symptoms remains incompletely understood. Although skin prick testing (SPT) and serum cat-specific immunoglobulin E (sIgE) are widely used in clinical practice, optimal diagnostic cut-off values may differ according to symptom status.

This retrospective cross-sectional study included children aged 0–18 years with documented cat allergen sensitization who underwent both SPT and sIgE testing between January 2023 and January 2025. Patients were classified as symptomatic or asymptomatic based on exposure-related clinical symptoms. Demographic data, comorbid allergic diseases, environmental exposures, laboratory parameters, and aeroallergen sensitization profiles were analyzed. Multivariate logistic regression was used to identify independent predictors of symptomatic response. Receiver operating characteristic (ROC) curve analyses were performed to evaluate diagnostic performance and optimal cut-off values.

A total of 428 children were included (217 symptomatic, 211 asymptomatic). Symptomatic patients had significantly higher prevalences of allergic rhinitis (91.7% vs. 83.4%, p=0.001), asthma (44.2% vs. 37.0%, p=0.035), food allergy (9.2% vs. 3.3%, p=0.008), and anaphylaxis (6.9% vs. 1.9%, p=0.021). Pollen sensitization was more frequent among asymptomatic children (83.4% vs. 74.2%, p=0.027). Total IgE levels and eosinophil parameters did not differ significantly between groups. In multivariate analysis, allergic rhinitis emerged as the strongest independent predictor of symptomatic cat allergy (adjusted OR 13.91, 95% CI 3.10–62.37), while male sex was also associated with increased risk (adjusted OR 3.11, 95% CI 1.16–8.30). Prenatal cat exposure showed a strong protective effect (adjusted OR 0.08, 95% CI 0.01–0.41). ROC analyses demonstrated high diagnostic accuracy for both SPT and sIgE, with higher optimal cut-off values observed in symptomatic patients compared to asymptomatic patients.

Symptomatic responses to cat exposure in sensitized children are strongly influenced by clinical context rather than laboratory markers alone. Symptom-specific cut-off values for SPT and cat-specific IgE may enhance diagnostic precision and support more individualized clinical decision-making.