Vergleichsuntersuchung der spezifischen IgE-Messung (Allergenteststreifen Allergodip Mites and More®) mit dem Hautpricktest und der nasalen Provokation bei Hausstaub- und Vorratsmilbenallergikern

Abstract

There have only been very limited published data dealing with correlations between skin prick test (SPT), in vitro diagnosis (IVD) (Allergen Dipstick) and nasal provocation (NP). We compared SPT with the results of allergen dipstick Allergodip Mites and More® and NP. The following mites were compared: house dust mites (HM): D. pteronyssinus (D. pter.), D. farinae (D. far.) and storage mites (SM): Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae. 108 patients who visited the ENT clinic complaining about chronic rhinitis were investigated. The SPT and IVD results were compared for both HM and SM and comparisons ofNP with SPT and IVD were made only for HM. SPT was classified in reaction 0 (negative), + (very weak positive), ++ (weak positive), +++ (= histamine positive control)/and ++++ (strong/very strong positive). IVD was classified in classes 0, 1, 2, 3, for comparison with NP. SPT: for the comparison of SPT with IVD the following correspondence was obtained: SPT 0/IVD class 0, D. pteronyssinus: 93.3%, D. farinae: 91.3% SM: Acarus siro: 95.2%, Lepidoglyphus destructor and Tyrophagus putrescentiae: 100%. SPT +++/++++/IVD > 1: HM D. pter.: 89.5% and D. far.: 94.2%. For the evaluation of SM, there were not enough patients. NP: correspondence SPT with positive NP, SPT ++++: 58.3% (D. pter.)/48.0% (D. far.), +++; 37.5%/40% ++: 4.2%/12.0% +: 0%/0%. 0:0%/0%. SPT with negative NP, SPT: ++++: 15.4%/13.0%, +++: 23.1%/ 17.4%, ++: 34.6%/30.4%, +: 11.5%/17.4%, 0: 15.4%/21.7%. NP positive, Allergodip class 4: 29.2% (D. pter.)/ 36.0% (D. far.), 3: 45.8%/36.0%, 2: 25.0%/20.0%, 1: 0%/4.0%, 0: 0%/4.0%. NP negative, Allergodip class 4: 0%/0%, 3: 11.5%/8.7%, 2: 7.7%/8.7%, 1: 23.1%/17.4%, 0: 57.7%/65.2%. Conclusion: The stronger the SPT reaction and the higher the classes measured with allergen dipstick the more a positive NP reaction was observed. For a positive NP there, seems to be a cut-off value for SPT of +++/++++ and for IVD of class > 2. The stronger the skin reaction (except SPT 0/IVD 0) the higher is the correspondence with the classes. There is no correlation between the degree of the skin reaction and the level of the classes. Patients with a strong skin reaction (+++/++++) do not necessarily show class 4, they may be lower. The only differentiation can be done in class 0 and ≥ 1. Futhermore, our investigation showed, that D. pter.-allergic patients are also sensitized to D. far. due to cross reactivity between these 2 mites. Some patients were also sensitized to storage mites.