Diagnostischer Algorithmus bei IgEvermittelter Holzstauballergie

Abstract

In the EU more than 3 million employers are exposed to wood dusts. This can induce irritative as well as allergic respiratory diseases. Sensitization prevalence between 3% for non-tropical wood species and up to 30% for tropical woods was documented. For sensitive and specific diagnosis of wood dust sensitization it is important to establish standardized test procedures and standardized test extracts. The diagnosis of wood dust allergy is often difficult because of missing commercial wood test extracts. In addition, cross-reactive carbohydrate detenninants (CCDs) can produce false positive test results. Especially in poly-sensitized patients specific IgE-measurement alone is not sufficient to evaluate the relevance of the wood dust sensitization. In these cases further diagnostic tests are necessary to identify the causing allergen of occupational problems. Provocation testing is the gold standard to ascertain clinical relevance of an allergen. In addition or as alternative, a combination of skin prick test (SPT), basophile activation test (BAT) and CCD-inhibition test can be applied to identify the relevant wood allergens.