Skin Prick Test In Patients Research Articles

Reacción adversa a contraste no iodado

Las reacciones adversas a medicamentos son relativamente frecuentes en la práctica clínica y algunas ponen en riesgo la vida. Las reacciones al medio de contraste representan un porcentaje importante de esas reacciones adversas. Se ha encontrado que 70% de las reacciones adversas a los medios de contraste iodados ocurren en los primeros cinco minutos tras su administración. A pesar de que las reacciones de hipersensibilidad inducidas por contraste tradicionalmente se clasifican como no alérgicas, en los últimos años los investigadores han reportado pruebas por punción positivas en pacientes con reacciones inmediatas como tardías. Se reporta el caso de una paciente con linfoma no Hodgkin que ha tenido en dos ocasiones reacciones adversas al contraste. Se comenta el tipo de reacción, la gravedad, el tratamiento profiláctico sugerido, pronóstico y recomendaciones, tomando en cuenta el padecimiento subyacente y la necesidad de hacer nuevos estudios de imagen.

Correlation between skin-prick testing, individual specific IgE tests, and a multiallergen IgE assay for allergy detection in patients with chronic rhinitis.

Allergy test results can differ based on the method used. The most common tests include skin-prick testing (SPT) and in vitro tests to detect allergen-specific IgE. This study was designed to assess allergy test results using SPT, individual specific IgE tests, and a multiallergen IgE assay (multiple allergen simultaneous test) in patients with chronic rhinitis and controls. One hundred forty total patients were prospectively enrolled in the study, including 100 patients with chronic rhinitis and 40 control patients without atopy. All eligible patients underwent SPT, serum analysis using individual specific IgE test, and multiple allergen simultaneous test against 10 common allergens. Allergy test results were then compared to identify correlation and interest agreement. There was an 81-97% agreement between SPT and individual specific IgE test in allergen detection and an 80-98% agreement between SPT and multiple allergen simultaneous test. Individual specific IgE test and multiple allergen simultaneous test allergy detection prevalence was generally similar to SPT in patients with chronic rhinitis. All control patients had negative SPT (0/40), but low positive results were found with both individual specific IgE test (5-12.5%) and multiple allergen simultaneous test (2.5-7.5%) to some allergens, especially cockroach, Dermatophagoides farina, and ragweed. Agreement and correlation between individual specific IgE test and multiple allergen simultaneous test were good to excellent for a majority of tested allergens. This study shows good agreement and correlation between SPT with individual specific IgE test and multiple allergen simultaneous test on a majority of the tested allergens for patients with chronic rhinitis. Comparing the two in vitro tests, individual specific IgE test agrees with SPT better than multiple allergen simultaneous test.

The effect of montelukast on wheal reactions in skin prick tests: A double-blind-placebo-controlled randomized trial

ObjectiveIt is well-known that number of drugs may interfere with wheal reactions in skin prick test. However, the effect of long-term use of montelukast, a cystenil leukotriene receptor antagonist, on skin prick test hasn’t been full elucidated. The aim of present study was to demonstrate the effect of montelukast on skin prick tests (SPT). MethodsThis is a single-center, randomized, double-blinded, placebo-controlled study including two treatment periods with a wash-out interval. The subjects received montelukast (5mg per day), fexofenadine HCl (60mg per day) and placebo (lactose) with a double-blinded manner during 7- and 21-days treatment periods with a 14 days wash-out period. Dermatophagoides farinae (D. farinae) was used as the skin test material, while histamine as positive control and normal saline as negative control. Overall, 7 skin prick tests were performed at following time points: before treatment periods, on the last days of both treatment periods, 24h after completion of treatment periods, and on the last day of 14-days interval. ResultsSixty house dust mite (HDM) allergic children (23 girls and 37 boys) with allergic rhinitis and/or asthma completed the study. Mean age was 8.3±2.0 years. In the fexofenadine group, a significant suppression was observed in post-treatment values when compared to baseline values in SPT with D. farinae (p=0.019). In the montelukast group, no significant suppression was observed in SPT with D. farinae at all time points when compared to baseline. ConclusionsOur results showed that montelukast had no effect on measurements of SPT. Thus, we concluded that there is no need to discontinue the treatment in order to perform SPT in patients receiving montelukast, even in those on montelukast treatment for at least 21 days.

232 Epidemiology of Allergic Rhinitis Cases in the Allergy Service of a Third Level Medical Center. Six Year Experience

BackgroundThe purpose of this study is to report the cases of Allergic Rhinitis (AR) in the Allergy service from a Third level medical centre since its creation in July 2005.MethodsThis is a descriptive, retrospective, transversal study from July 2005 to February 2011. Selected medical records of patients apply for diagnostic criteria for an allergy disease were made. ARIA guide 2009 was used to make diagnosis of allergic rhinitis. Patients were classified by age and sex and find out how many skin prick test were made in such patients, and how many patients began immunotherapy.Results13737 consultations were attended in the Allergy service between the period mentioned above. 2337 medical records of patients were selected, 1608 patients applied for a specific diagnosis for an allergy diseases as follows: Asthma 411, Atopic conjuctivitis 58, Atopic Dermatitis 180, Allergic Rhinitis 869, Urticaria 90. 869 patients completed criteria for Allergic Rhinitis. 433 (49.9%) patients were female, 436 (50.1%) patients were male. 490 (56.3%) patients were found to be in the range of 0 to 14 years. The mayority of allergic rhinitis patients were males in the range of 5 to 14 years, with 270 (42.5%) patients. There were an increase of AR cases in females in the range of 20 to 40 years, with 171 (39.4%) of total female cases. In 408 (47%) patients skin prick test were made, in 305 (35%) patients were positive and began treatment with immunotherapy.ConclusionsIn this study, AR represents the most frequent allergy disease among children, a good diagnosis of AR is mandatory because of the confusion of symptoms mainly related with upper respiratory tract infections, that implies a different management, increasing the risk of complications, such as asthma and therefore the cost of treatment, including immunotherapy. The results of this study are helpful to improve specialized medical attention not only in paediatric patients but also in adults.

The relationship between symptoms and the results of the skin prick test in patients with allergic rhinitis

To determine the relationship between skin prick test results and allergic symptoms and to discover which symptom or symptoms are more commonly associated with the skin prick test. Materials and methods: Of the 1462 patients with a prediagnosis of allergic rhinitis (AR) who underwent the skin prick test, 495 subjects completed the symptoms inquiry form and were included in the study. Results: Out of 495 cases, the skin prick test was found to be positive in 358 and negative in 137. No significant relationship was found between sneezing, runny nose, itchy nose, nasal obstruction, headache, postnasal drip, and skin prick test positivity (P > 0.05). There was a significant relationship between ocular complaints (watering, itching, discharge) and skin prick test results (P = 0.027). The groups with positive and negative skin prick test results were compared in terms of symptom severity. While the difference between itchy nose and ocular symptoms was found to be significant, this difference was not significant in terms of nasal obstruction, postnasal drip, and sneezing. Conclusion: While no significant relationship was found between symptoms accepted as allergic, such as sneezing and itchy nose, symptoms such as eye itching and watering were found to be related to allergy. We recommend performing the skin prick test routinely on patients presenting with AR symptoms. This would also prevent unnecessary antihistamine use.

Heat and pressure treatments effects on peanut allergenicity

Peanut allergy is recognized as one of the most severe food allergies. The aim of this study was to investigate the changes in IgE binding capacity of peanut proteins produced by thermal-processing methods, including autoclaving. Immunoreactivity to raw and thermally processed peanut extracts was evaluated by IgE immunoblot and skin prick test in patients with clinical allergy to peanut. Roasted peanut and autoclaved roasted peanut were selected for IgE ELISA experiments with individual sera, immunoblot experiments with antibodies against peanut allergens (Ara h 1, Ara h 2 and Ara h 3), digestion experiments, and circular dichroism spectroscopy. In vitro and in vivo experiments showed IgE immunoreactivity of roasted peanut proteins decreased significantly at extreme conditions of autoclaving. Circular dichroism experiments showed unfolding of proteins in autoclave treated samples, which makes them more susceptible to digestion. Autoclaving at 2.56atm, for 30min, produces a significant decrease of IgE-binding capacity of peanut allergens.

Prediction of atopy by skin prick tests in patients with asthma and/or persistent rhinitis

Background Patient history gives important clues about the likelihood of atopy. However, the accuracy of assessment of atopy based on detailed allergy history is low. The objective of this survey was to determine the successful prediction rate of atopy by a questionnaire and the effect of various factors on the successful prediction. Methods A standard questionnaire including detailed allergy history was filled in by two experienced allergists for 169 patients having bronchial asthma and/or persistent rhinitis symptoms. Skin prick test (SPT) results were predicted based on the clinical data obtained by a questionnaire. Final diagnosis was made after SPT. Sensitivity and specificity analysis of SPT results prediction was investigated using two different cut-off values (3 mm and 5 mm) for positive tests, and factors associated with successful atopy prediction were analysed. Results SPT was predicted to be positive in 42.6% and was positive in 36.1%. Depending on SPT results with the cut-off value 3 mm, prediction sensitivity was 77%, specificity was 65.3%, positive predictive value was 65%, and negative predictive value was 86%. Successful positive atopy prediction was associated with age; true negative prediction was also associated with age and high education. With the threshold of 5 mm for a positive test, sensitivity, specificity, positive and negative predicted values were 91%, 61%, 14% and 99%, respectively. Conclusion It seems that the success rate of detailed history is high for negative prediction. However, detailed history alone does not seem to be efficient for atopy prediction.

Clinical Relevance Of Profilin Sensitization Evaluated With Skin Prick Test In Patients With Grass Allergy: A Multicenter Study.

Clinical Relevance Of Profilin Sensitization Evaluated With Skin Prick Test In Patients With Grass Allergy: A Multicenter Study.

Evaluation of High Speed Laser Doppler Imaging Technology to Measure Skin Prick Tests in Daily Allergologic Practice

RATIONALE: Skin prick tests (SPT) are commonly used in daily allergologic practice to evaluate skin reactivity to various allergens. The current visual evaluation of SPT is observer dependent. To evaluate an objective measurement of skin reactivity to SPT, we compared the classical visual reading (CVR) with a method of high speed laser Doppler imaging (HS-LDI). METHODS: First, SPT, including positive and negative controls, birch and grass pollen extracts (Stallergenes, France) were applied to 20 volunteers (10 atopics, 10 non atopics) to determine tests characteristics (cut-off, optimal reading time and allergen concentration). Then 20 atopic patients were tested, with optimal allergen concentration and time window, with birch and grass pollen extracts and skin reactivity was measured with CVR and HS-LDI. RESULTS: The optimal concentration was 1/1 whereas the optimal time window for the lecture of SPT with HS-LDI was 5-10 min. for histamine and 10-15 min. for allergens. The sensitivity of CVR was 93% and of HS-LDI 100%, whereas the specificity of CVR was 94% and of HS-LDI 82%. CONCLUSIONS: The lecture of SPT with HS-LDI proved to be a simple and more sensitive but less specific method than CVR. Its future application could be the lecture of SPT in patients showing doubtful results with CVR and in clinical trials where an objective method of reading of SPT is needed.

A study of skin sensitivity to various allergens by skin prick test in patients of nasobronchial allergy.

Objective:To study skin sensitivity to various allergens in patients of nasobronchial allergy.Materials and Methods:2880 skin prick tests with 60 allergens were performed in 48 patients of nasobronchial allergy.Results:Most common offending allergens were insects (21.2%), followed by dusts (12.0%), pollens (7.8%), animal dander (3.1%), and fungi (1.3%). The common insect antigen were locust female (33.3%) followed by locust male (25%), grasshopper (20.8%), cricket (16.7%), cockroach female (16.7%) and cockroach male (14.6%). Common dust allergens were house dust, wheat dust, cotton mill and paper dust. Among pollens, Amaranthus spinosus, Argemone mexicana, Adhatoda vasica, Ailanthus and Cannabis were found to be common allergens. In animal danders common offending allergens were cow dander and dog dander. Among fungi Aspergillus fumigatus, Aspergillus flavus, Alternaria teneis and Fusarium sodani were common allergens. Patients of bronchial asthma had associated allergic rhinitis in 80% cases.Conclusion:Common allergens in patients of nasobronchial allergy were identified. The data may prove useful in of allergen avoidance and immunotherapy in these patients.

Tratamiento de la hiperglucemia: ¿hasta dónde los objetivos de control?

To review the efficacy of anti-IgE therapy in allergic rhinitis (AR).Literature search was performed using the PubMed and Proquest Central databases at Kırıkkale University Library.Although the skin prick testing in patients suffering from AR is positive (indicating that antigen-specific Immunoglobulin E has been produced), there is no association with overall circulating IgE levels. Correlation was lacking between circulating IgE level and either skin prick tests or laboratory testing for specific IgE. Omalizumab binds to uncomplexed IgE in man more avidly than does Fc-epsilon. The effect of omalizumab is to lower the level of IgE and downgrade production of FceRI receptors (which bind IgE) in mast cells and basophils, causing less mast cell recruitment and responsivity and thus diminishing eosinophilic infiltration and activation. Anti-IgE therapy through omalizumab may shorten the lifetime of mast cells and causes dendritic cells to downgrade their production of FcεRI. There are reports indicating benefit from omalizumab in managing food allergies, nasal polyp formation, essential anaphylaxis, AR, venom allergy and eczema. Omalizumab acts to lessen circulating IgE levels, whilst reducing production of FceRI by mast cells and basophils. The fact that omalizumab influences how eosinophils respond may be down to disruption of the antigen-IgE-mast cell interactions, with mast cells being recruited at lower levels and thus chemotactic eosinophilic recruitment via cytokines being greatly reduced. Omalizumab has the effect in cases of perennial AR of blocking the increased eosinophilic recruitment and tissue infiltration initiated by seasonal antigens. Likewise, in omalizumab-treated cases, circulating unbound IgE levels showed significant decreases. For patients with perennial AR, the average daily nasal severity score was significantly reduced where omalizumab was administered, compared to placebo.Omalizumab has efficacy in ameliorating symptoms and reduces the necessity for additional medication in both seasonal and perennial allergic rhinitis

Prevalence and relevance of the positivity of skin prick testing in patients with chronic urticaria

Many patients with chronic urticaria (CU) worry that foods or other allergens are responsible for their urticaria. Skin prick testing (SPT) may be one of the investigations used to provide a clear illustration. The purpose of our study was to assess the prevalence of positivity of SPT to food allergens and aeroallergens and their relevance in patients with CU, in order to demonstrate the diagnostic value of SPT in CU. We retrospectively reviewed case record forms of patients with chronic ordinary urticaria who underwent SPT in the Urticaria Clinic, Siriraj Hospital, during the period 2000-2004. The studied allergens included 16 food allergens and 12 aeroallergens. Eighty-eight patients were enrolled. The prevalence of positive SPT among patients with CU was 47.7%. Patients who had personal histories of atopy had statistically significant positive SPT results compared with patients who had negative SPT. Of 88 patients, 26 patients (30%) gave positive results to food allergens, 36 patients (41%) gave positive results to aeroallergens and 20 patients (22.7%) gave positive results to both food and aeroallergens. One-third of the subjects (34.6%) who had positive SPT results to food allergens had clinical relevance of food allergy in some systems but only one patient had clinical relevance of food-induced urticaria. Half of the patients who had a history of aeroallergen sensitivity gave a positive SPT response for aeroallergens; however, there was no clinical relevance to their CU. Our study showed that the prevalence of positive SPT to food allergens and aeroallergens in patients with CU was common but had little clinical relevance to CU.

Prevalence of specific aeroallergen sensitivity on skin prick test in patients with allergic rhinitis in Westchester County

Allergic rhinitis is the most common cause of rhinitis, and is often the diagnosis prompting referral to the allergist for skin prick tests (SPT). The prevalence of positive SPT to different aeroallergens varies with the geographic setting. Westchester County is located in the state of New York, and there are no local data to date reflecting the prevalence of positive SPT. We therefore undertook a study to determine the reactivity to aeroallergens in the local population. The results of SPT to 48 aeroallergens and 2 controls were analyzed in 100 patients referred for allergic rhinitis. 65% had a positive SPT to at least 1 aeroallergen. Amongst the molds, alternaria positivity was noted in 8%, cat hair reacted in 18%, birch antigen was positive in 20% and reactivity to grass mix antigen was observed in 24%. The antigen showing the greatest SPT positivity was the house dust mite (30%). Sensitization rates for other antigens are presented.

Skin prick test results of child patients diagnosed as bronchial asthma

Background The pathogenesis of asthma is associated with both genetic and environmental factors. Allergen sensitization is an important risk factor in asthma development. Aim To evaluate sensitivity to allergens by using the skin prick test in patients with a diagnosis of bronchial asthma. Method Patients with a diagnosis of bronchial asthma followed-up at the Ministry of Health, Diskapi Children's Diseases Training and Research Hospital in Ankara (Turkey) between January 1995 and March 2000 were included. Sensitivity to allergens, as determined by the skin prick test, was evaluated retrospectively. Results The files of a total of 3025 children (63.3 % boys) with bronchial asthma, aged 3 months to 16 years were evaluated. Of the total, 1667 patients with a diagnosis of bronchial asthma and 1358 with bronchial asthma plus allergic rhinitis were under follow-up. Of the 3025 asthmatic patients, 1902 had undergone the skin prick test and 60.3% of these patients were atopic. The most common allergens were house dust mite [726 patients (63.3 %)], followed by pollens [565 patients (49.3 %)]. The most common allergen within this group was grass pollens [348 patients (30.3 %)]. Conclusions Atopy was an important risk factor in our patients and the most common allergens were aeroallegens. The development of sensitization could be delayed by early precautions.

Respiratory Symptoms, Spirometry and Skin-Prick Tests in Patients with a Family History of Asthma: A 12-year Follow-up

Respiratory Symptoms, Spirometry and Skin-Prick Tests in Patients with a Family History of Asthma: A 12-year Follow-up

The natural course of atopy determined by skin prick tests in patients with bronchial asthma and/or rhinitis

Background The skin prick test (SPT) is the cheapest, most widely used and practical method for the diagnosis of allergic diseases. The results of repeat test might show variations due to aging. Objective To perform repeat SPTs to determine possible changes in the atopy rate in general as well as changes in the allergen spectrum of atopic patients occurring over time and to identify the factors that could affect this change. Methods A total of 222 patients who received a diagnosis of bronchial asthma and/or persistant rhinitis in our Adult Allergy Unit and who attended follow-up visits in the outpatient unit over a 2-year period were enrolled. SPT with 10 visit common aeroallergens were performed at the first and the second test was performed after an interval of at least 2 years. Results The mean age was 36.4 ± 11.4 years and 77.5 % of the patients were women. The mean interval between the two tests was 43.4 ± 20.0 (minimum = 24-maximum = 105) months. Repeat tests showed that the atopy rate decreased from 58.6% to 47.7 %; sensitivity rates to 10 allergens also decreased. These differences were statistically significant (p < 0.05). Conclusion The atopy rate determined by SPTs tends to decrease over time. The most important factor affecting this decrease is time itself.

Skin Prick Tests in Patients with Chronic Urticaria

Acute or chronic urticaria is not a common manifestation of systemic disease. However it affects 15% of the population at least once during their lives. The most common causes of urticaria are allergic. In all, we studied 130 patients (mean age 54.8) with chronic urticaria, 88 women and 42 men, in an effort to identify common causes of urticaria, using environmental and food allergens. 90 of our patients (69.2%) did not present with skin sensitivity. The remaining 40 individuals presented with skin sensitivity: 20 (15.3%) to food allergens, 14 (10.7%) to environmental allergens and 6 patients (4.6%) to both allergens (environmental and food). We note that in chronic urticaria it is unusual to find underlying causes.

Relative utility of skin prick tests, total IgE and allergen-specific IgE in allergy diagnosis

Rationale The study assessed the correlation between skin prick test (SPT), determination of specific IgE antibodies and total serum IgE in patients with a history of allergic disorders. Methods 48 patients, 31 females and 17 males, age 16 to 65 years old were studied by SPT, total IgE and allergen-specific IgE. 27 patients had respiratory disorders, 15 had skin disorders and 6 had a history of systemic allergic reactions after insect stings. Results In 8 patients SPT and specific IgE were negative, 1 of whom had a slightly increased total IgE. In 8 patients SPT and specific IgE were positive, 4 of whom had increased total IgE. Among 10 patients who had dermographism and positive specific IgE, 6 had an elevated total IgE. 19 patients having negative SPTs had positive specific IgE assays, 9 also having a high level of total IgE. Conclusions There was no significant correlation between SPT and specific IgE tests, or between SPT and total serum IgE level. When SPT is positive and in agreement with the clinical history, the total and specific IgE add no additional useful information. However, in patients having dermographism or negative SPT, total and specific IgE determination may assist in confirmation of the diagnosis.

Positive skin prick tests in patients with and without clinical manifestations to peanuts

Rationale Significant mortality rates are associated with peanut allergy. Determining the factors that are predictive of future reactions to peanuts is essential. Methods A survey was mailed to caregivers of 192 patients, below the age of 18 years, with a diagnosis of peanut allergy in a suburban private allergy practice. The diagnosis of peanut allergy was made by epicutaneous skin prick tests (SPT). The age of peanut allergy diagnosis, type of reaction, and history of personal and family atopic disease was addressed. Comparisons between groups were made using unpaired t tests. Results One hundred seven surveys (57%) were returned. Ninety-four patients had a positive history of symptoms with exposure to peanut-containing products. Thirteen patients had a positive SPT with no prior history of reaction to peanuts. Of these patients, two (15%) developed allergic reactions during SPT. At the time of diagnosis, patients with a history of allergic reactions to peanuts were significantly older (2.4 years) than those without a history of prior reactions to peanuts (1.6 years) (p<0.01). Patients with severe reactions, ie: respiratory symptoms, were significantly older than patients without a prior history of reactions (p<0.05). Among the patient groups with multi-systemic, cutaneous, or no prior history of reactions, the size of the wheal during SPT was not different (p>0.05). Conclusion Older patients with peanut allergy are more likely to have a history of severe reactions. In patients without a prior history of reaction to peanuts, a positive SPT may suggest future risk of reactions. Further studies are needed to support this theory.

Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region

Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region