Abstract
Objectives. – Studies performed to assess the diagnostic value of tests for hymenoptera allergy are usually designed to validate the test whereas very few have evaluated these tests in routine diagnostic situations. In fact, the diagnostic value of such tests, especially skin prick-tests and basophil histamine release, has rarely been studied systematically in patients referred by their physician to an allergist for confirmation of the diagnosis and recommendations for immunotherapy. The aim of the present study was to assess the diagnostic value of skin prick-tests, specific IgE assay and basophil histamine release in patients referred to an allergy unit for suspected hymenoptera venom allergy. Patients and methods. – Diagnostic tests were done prospectively in 25 consecutive patients with allergic reactions to hymenoptera venom defined by clinical history and positive intradermal skin tests, including patients with a localized or a more extensive skin reaction associated with malaise and/or respiratory symptoms, and in 21 control subjects. The hymenoptera studied included yellow jacket (YJ) and honeybee (HB). The sensitivity, specificity, concordance and predictive values of the tests were calculated. Results. – The observed sensitivity, specificity, and positive and negatives predictive values of skin prick-tests with 100 μg/mL HB venom (in percent) 33.3; 100; 100; and 85.7, respectively, and with 100 μg/mL YJ venom 30; 100; 100 and 85, respectively. For skin prick-tests with 300 μg/mL HB venom the values were 75; 100; 100 and 94, respectively and for skin prick-tests with 300 μg/mL YJ venom 57; 100; 100 and 90.3, respectively. For specific IgE assays, the values for HB were 100; 95.2; 84 and 100, respectively and for YJ 100; 76.2; 51.2, and 100, respectively. For basophil histamine release the values for HB were 89; 100; 100 and 97.3 for YJ they were 94; 89, 6 and 98.4, respectively. Conclusions. – Skin prick-tests with venom concentrations under 300 μg/mL are not sensitive enough for an accurate diagnosis of hymenoptera allergy. Basophil histamine release appears to be a good complementary test but it needs better standardization.
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More From: Revue française d'allergologie et d'immunologie clinique
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