Skin Prick Test Results Research Articles

Coconut allergy: Characteristics of reactions and diagnostic predictors in a pediatric tertiary care center

BackgroundLittle is known on the clinical manifestations of coconut allergy. Our knowledge to date is mainly based on case reports. ObjectiveTo characterize the allergic reactions to coconut and suggest diagnostic cutoffs for specific immunoglobulin E (sIgE) and skin prick testing (SPT) to predict clinically reactive coconut allergy. MethodsMethods include retrospective chart review at an urban tertiary care center of patients with positive testing result for coconut. Probability curves were computed by logistic regression for SPT and coconut sIgE. ResultsOf 275 records reviewed, 69 patients reported coconut reactions and 206 were sensitized only or nonallergic. The reactions occurred with breastfeeding (n = 2), contact (n = 10), or oral ingestion (n = 57). Approximately 50% of oral ingestion reactions were associated with mild/moderate anaphylaxis. Clinical reactivity vs sensitization was more common in topical coconut users (2-fold) (P = .02). Although not statistically significant, there was a trend toward more coconut allergy vs sensitization in Asian and African American patients. The probability of allergy with positive SPT result was approximately 50% and with sIgE was approximately 60%. At an SPT of 9 mm wheal or sIgE of 58 kU of allergen/L, there is a 95% probability of reaction. Cosensitization with tree nuts, legumes, and seeds was common. Macadamia nut had the strongest correlation with coconut (r = 0.81, P < .001, n = 101). ConclusionAlthough the rate of reactivity to coconut in sensitized individuals is low, half of the reactions from consumption met the criteria for anaphylaxis. Clinicians should be aware of the spectrum of reactions and diagnostic use of sIgE and SPT.

Prick and intradermal skin tests in patients with severe hymenoptera sting allergy using commercial versus in-house allergen extracts.

Fire ant, honey bee, and wasp allergen extracts are useful in the diagnosis and treatment of severe Hymenoptera allergic patients. To evaluate the result of skin prick test (SPT) and intradermal test (ID) compared between local and commercial insect allergen extracts in patients with severe Hymenoptera sting allergy. SPT and ID using local and commercial insect allergen extracts were performed. Specific IgE (sIgE) to honey bee, wasp, and fire ant; component-resolved diagnosis (CRD); (rApi m1, rApi m2, rApi m3, rApi m5, rApi m10, rVes v5, rPol d5, and rVes v1); and, cross-reactive carbohydrate determinant (CCD) were performed. Twenty-seven patients were included. Twenty-five had anaphylaxis, and 2 had severe systemic skin reaction. Positive skin test (SPT and/or ID) result from local and commercial allergen extracts was 74% vs. 67% for fire ant, 48% vs. 59% for honey bee, and 52% vs. 74% for yellowjacket. Local and commercial allergen extracts showed substantial agreement for fire ant (k = 0.647, p = 0.001) and honey bee (k = 0.632, p = 0.001), and moderate agreement for wasp (k = 0.547, p = 0.001). When compared with sIgE subtracted with CCD and/or CRD, skin test results of local fire ant allergen extract showed higher sensitivity (87% vs. 67%), specificity (42% vs. 33%), and accuracy (67% vs. 52%) than commercial extract. Commercial honey bee and wasp showed higher sensitivity (62% vs. 50%, 85% vs. 65%) and accuracy (63% vs. 52%, 78% vs. 70%), respectively. SPT and ID with local or commercial insect venoms could help in confirming and/or identifying the causative insects.

Aspirin Exacerbated Respiratory Disease and Nasal Polyp Phenotyping.

Aspirin exacerbated respiratory disease (AERD) is known by the triad of chronic rhinosinusitis with nasal polyposis (CRSwNP), aspirin hypersensitivity, and asthma, but its etiology and physiopathogenesis are still unclear. This cross-sectional study was designed to investigate allergy and inflammatory cells (neutrophils vs. eosinophils) dominancy in nasal polyp tissue of patients with AERD compared to non-AERD patients. CRSwNP patients scheduled for endoscopic sinus surgery were recruited in this study. Nasal polyp tissue was analyzed for infiltrating cells, and Eosinophil dominant and neutrophil dominant polyps were determined. AERD was confirmed by oral aspirin challenge (OAC). Demographics data; history of asthma, exacerbation by using NSAIDs, routine use of aspirin, type of surgery (primary or revision), and results of skin prick test and spirometry were recorded. Pathology results and contributing factors compared between AERD and non-AERD patients. Sixty-five patients (39 women, 26 men) were enrolled in the study (mean age 38.83 ± 12.43 years). Thirty (46%) patients had positive OAC tests. Totally 41 patients (63.1%) had eosinophilic polyps. 80% of patients with eosinophilic polyp had positive OAC and were AERD (P < 0.05). There was no significant difference in demographics, revision surgery, and concomitant asthma between AERD and non-AERD groups (P > 0.05). The positive skin prick test was higher in AERD and also in eosinophilic polyp patients, but it was not statistically significant (P = 0.086 and P = 0.177). Eosinophilic polyps are more common in AERD. A positive skin prick test is associated with AERD and eosinophilic polyp.

ASSESSMENT OF ALLERGIES TO FOOD AND ADDITIVES IN PATIENTS WITH ANGIOEDEMA, BURNING MOUTH SYNDROME, CHEILITIS, GINGIVOSTOMATITIS, ORAL LICHENOID REACTIONS, AND PERIORAL DERMATITIS.

SUMMARYOral cavity and perioral area are constantly exposed to a variety of antigens, including food and additives, which have a potential role in the development of different oral mucosal and perioral cutaneous diseases since they can cause hypersensitivity reactions. Oral and perioral diseases mainly include angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reactions, and perioral dermatitis. Previous studies were focused on delayed-type oral allergies by performing patch testing but did not include tests for immediate-type allergic reactions. Therefore, the objective of this study was to determine common nutritive and additive allergens in the prevalent oral and perioral diseases by using skin prick tests. Our study evaluated 230 participants, i.e. 180 patients with oral/perioral diseases (angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reactions, and perioral dermatitis), and 50 healthy control subjects. The results of skin prick tests showed that immediate-type allergic reactions to food and additives were mostly seen in patients with burning mouth syndrome (40%) and cheilitis (33.3%), whereas allergies were least frequently observed in perioral dermatitis (10%) and gingivostomatitis (20%). Fruits, mushrooms, and vegetables were the most frequent causes of nutritive allergies in oral and perioral diseases. The most commonly identified additive allergens were glutaraldehyde, citric acid, and sodium glutamate. Study results suggest the possible association with nutritive and additive allergies be considered in cases of persistent oral mucosal or perioral skin disease accompanied by respective medical history.

Evaluation of angiotensin converting enzyme inhibitors (ACEI) induced side effects in allergology department

Background and aim. ACEIs are extensively used in cardiac diseases and among their main side effects there are dry cough and angioedema. The aim of this study is to evaluate the patients who are presenting to an allergologist for a suspicion of side effects induced by ACEI. Material and methods. Forty-two patients with arterial hypertension treated with ACEI, who have presented dry cough and/or angioedema as side effects, were included. The patients were evaluated between 2014 and 2016 in one allergology department from Cluj-Napoca. The data were collected from the files and were statistically analyzed using SPSS v.21. The allergological evaluation included anamnesis data that were recorded in patients files and the results of skin prick test performed at the initial presentation. Results. Females were more likely than men to have side effects (64.3% versus 35.7%). Half of the patients were treated with perindopril. Most of the patients (59.5%) were referred to the allergology department for dry cough. Angioedema was more commonly observed in men, while cough was a frequent side effect in women, with no statistical significance (p = 0.150). There is no correlation between the used ACEI and the type of side effect (p = 0.45) or the number of angioedema episodes (p = 0.51). The persistence of the symptoms in spite of treatment cessation was observed in case of perindopril and enalapril (p = 0.05) and in case of atopy presence (p = 0.03). Conclusions. Cough and angioedema are common side effects of the whole class of ACEI. The type of adverse events might be correlated with the patient’s gender. The presence of atopy may increase the risk of symptoms persistence.

Sensitization to house dust mite allergens might be related to the low sensitivity of ImmunoCAP to pollen allergen.

Skin prick test (SPT) and ImmunoCAP are widely used to diagnose allergies. However, previous studies showed discordance between the results of SPT and ImmunoCAP and there remains a lack of research to better understand the differences in results between the two tests. We investigated factors that affected the discordance between SPT and ImmunoCAP results. We reviewed the medical records of 94 subjects who underwent both SPT and ImmunoCAP for six allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, alder, ragweed, mugwort, and Humulus japonicus). We retrospectively analyzed whether age, sex, body mass index, and allergic sensitization to house dust mite (HDM) or seasonal allergens affected the discordance of results between SPT and ImmunoCAP. The positivity rates for HDM allergens were similar between the two tests. For seasonal allergens, however, the positivity rates were much higher in the SPT than those in the ImmunoCAP. The concordance rates of the two tests were relatively higher for HDM than seasonal allergens. Moreover, the ratio of the subjects positive by SPT and negative by ImmunoCAP was higher for seasonal allergens. Positivity for HDM allergens by SPT resulted in a higher rate of mismatch between the two tests for seasonal allergens. The ImmunoCAP test for seasonal antigens showed low positivity rates compared to SPT in cases positive for HDM allergens. This suggests that the results of ImmunoCAP are less sensitive for seasonal allergens compared to the SPT in cases positive for HDM allergens.

Cross-reactivity in Skin Prick Test Results of Members Within Pooideae Subfamily.

ObjectiveMolecular similarities of grass pollen antigens have led to the view that cross-reactivity exists within members of the Pooideae subfamily of grasses. This has resulted in testing for only the most antigenically representative member of Pooideae, Timothy grass (Phleum pratense), despite little literature to support the claim that Phleum is the most representative member or that in vitro cross-reactivity correlates with in vivo cross-reactivity. The aim of the study was to determine if patients with allergic rhinitis symptoms and positive skin prick test results to meadow fescue (Festuca pratensis) also have positive results to Timothy grass.Study DesignRetrospective cross-sectional study.SettingTertiary care center in middle Missouri.MethodsA retrospective chart review identified patients ≥12 years old with a diagnosis of allergic rhinitis who underwent skin prick testing between March 2016 and July 2018, by using a search with CPT code 95004 (Current Procedural Terminology). Positive skin prick test results were based on wheal produced ≥3 mm than the negative control.ResultsAfter review of 2182 charts, 1587 patients met criteria to test for Phleum and Festuca. In total, 1239 patients had a positive result for Phleum or Festuca. Of these, 479 (38.6%) tested positive for Festuca alone, while 342 (27.6%) and 418 (33.7%) tested positive for Phleum alone and Phleum+Festuca, respectively.ConclusionClinical cross-reactivity among Pooideae members may not be as complete as traditionally thought. P pratense may not be the most antigenically representative subfamily member, and other grasses may need to be included in skin prick testing.

Pattern of allergic sensitization in chronic rhinitis: A 19-year retrospective study.

The pattern of allergic sensitization provides data for physicians to take appropriate care of allergic patients. To analyze the long-term pattern of allergen skin prick test (SPT) sensitization at a single tertiary care hospital in Thailand. Medical records of adult rhinitis patients during 1998 to 2017 were reviewed. Inclusion criteria were chronic rhinitis with positive SPT to at least one aeroallergen in the test panel. Outcome measures were SPT results, clinical symptoms, and their effect on patient quality of life (QoL). Descriptive statistics were used to demonstrate the pattern of sensitization. Multivariate linear regression was used to identify association between evaluated factors and patient QoL. Six thousand five hundred and seventeen adult patients were included in this study. Mean age was 36.4 & 13.8 years. A majority of patients (59.4%) had positive SPT, and 83.7% of those had polysensitization. Dermatophagoides pteronyssinus and sedge were the most common indoor (54.8%) and outdoor allergens (37.7%), respectively. Compared among the various periods of data collection over a 19-year period, there was no major change in the pattern of sensitization. Considering the most recent data from 2013-2017, the prevalence of sensitization increased from 66.8% to 73.7% (p < 0.001). Clinical symptoms, except sneezing and allergen sensitization, affect QoL of chronic rhinitis patients (p < 0.001). House dust mite and sedge are the most common indoor and outdoor allergens. There was no major change in the pattern of sensitization. Almost all allergic symptoms significantly affect QoL.

Clinical History Matters, Skin Prick Test (SPT) Results are Not the Be-All and End-All for Allergy Diagnosis

Clinical History Matters, Skin Prick Test (SPT) Results are Not the Be-All and End-All for Allergy Diagnosis

SPECTRUM OF CAUSATIVELY RELEVANT AEROALLERGENS OF SOUTHERN UKRAINE WHICH PROVOKE ALLERGIC REACTION IN PATIENTS WITH POLLINOSIS ON THE EXAMPLE OF KHERSON REGION

The aim: the analysis of spectrum of causatively relevant aeroallergens of southern Ukraine which provoke allergic reaction in patients with pollinosis. Materials and methods: ambulatory medical records data and skin prick-testing results of 477 patients afflicted with pollinosis in Kherson (250 women - 52,41 % and 227 men - 47,59 %) aged from 19 to 66 years old (38,05±0,45) have been analyzed retrospectively. Results: all patients revealed clinical implications mainly during the September-October period. Clinically 151 patients (31,66%) showed severe and 326 (68,34%) moderate to severe clinical progression. Composite family plants (composites) proved to be the most widespread plants (69,76 %) among all pollen aeroallergens of Kherson region. Weeds and sunflower showed the highest percentage among composites: Ambrosia topped to 79,87 %, Helianthus (sunflower)- 75,68 %, Artemisia - 42,98 %, and Cyclachaena (sump weed) - 36,48 %. Wild and cultivated grains' aeroallergens toped to 28,22 %. Among them the sensibility to Lolium perenne (19,28 %), Festuca pratensis (17,82 %), Dactylis glomerata (17,82 %) has been noticed more often. Tree aeroallergens topped to 2,03 %. Conclusions: The third wave of pollen formation (September-October period) appeared to be the most significant and clinically hard for Kherson region. According to the specific allergologic research data, allergens of the composite family plants, among which pollen of Ambrosia, Helianthus, Artemisia and Cyclachaena cause more frequent sensibility, turned to be the most widespread causatively relevant aeroallergens in Kherson region which provoke allergic reaction in patients with pollinosis. The second place was taken by wild and cultivated grains' aeroallergens, among which sensibility to Lolium perenne, Festuca pratensis, Dactylis glomerata proved to be the most common.

Negative penicillin skin testing induced anaphylaxis with concurrent beta blocker and angiotensin-converting enzyme inhibitor use

Penicillin allergy occurs at a prevalence rate of 0.7% to 10% in adults and children.1 Hypersensitivity to penicillin is typically evaluated with a protocol that consists of skin testing with skin prick and intradermal tests, followed by an oral amoxicillin challenge if the former test results are negative.2,3 Recent studies have revealed that drug hypersensitivity may be directly evaluated by an oral challenge without a preceding skin test in low-risk populations.4,5 We present the first case of anaphylaxis following negative results of skin prick and intradermal tests with penicillin and benzylpenicilloyl polylysine.

STUDY OF THE EFFICIENCY OF ALLERGEN IMMUNOTHERAPY IN PATIENTS WITH ALLERGIC RHINITIS

Allergen immunotherapy is one of the effective treatments for many allergic diseases. The principle of allergen immunotherapy is to achieve tolerance to causative allergens. The effectiveness of allergen immunotherapy depends on the correct diagnostic approach, the quality of the vaccine and patient compliance.&#x0D; This article presents the analysis of the effectiveness of the allergen immunotherapy using sublingual and subcutaneous methods of administration in patients with allergic rhinitis. The study group consisted of 236 patients with allergic rhinitis, 126 (53.4%) female and 110 (46.6%) male individuals aged 32.6 ± 2.4 years. Clinical and laboratory data collection, instrumental, cytological, specific allergological studies (total IgG4, skin prick-tests, molecular studies ALEX) were carried out. The efficacy of the аllergen immunotherapy was assessed by a combined symptom medication score. According to the results of skin prick-tests, it was determined that 163 (69.0%) people had polysensitization, 61 (25.8%) individuals had monosensitization, and 12 (5.2%) had negative skin prick-tests. ALEX component studies were performed for 52 people. The most common major components found were Phl p 1, 69.2%, Lol p 1, 57.7%, Der f 2, 48.1%, Der p 2, 42.3%, Bet v 1, 34.6 %. Minor components Phl p 7, Phl p 12 were detected in 9 (17.3%) patients. According to molecular studies, the prognostic efficiency of the аllergen immunotherapy was defined as high in 41 people and as average in 9 people; 86 patients with allergic rhinitis took the allergen immunotherapy: 37 people by sublingual route, and 49 people by subcutaneous methods. There was a significant decrease in the overall assessment of symptoms, medication needs, and a comprehensive assessment that did not depend on the method of administration of the allergy vaccine. Comparative analysis of total IgG4 levels before and in the third year of the allergen immunotherapy showed only a tendency to increase (p = 0.492). The component-resolved diagnosis plays an important role in choosing a treatment strategy for patients with allergy and predicting the efficacy of the allergen immunotherapy. Allergen immunotherapy, regardless of the methods of its introduction, shows high clinical efficacy in patients with allergic rhinitis that was confirmed by the criteria of combined evaluation. Assessment of total IgG4 levels has not had a reliable diagnostic value as a biomarker of the immunological response to the allergen immunotherapy.

Aeroallergen sensitisation patterns of children aged 5 years and younger with asthma and/or allergic rhinitis in Istanbul

Aim of the studyThe purpose of the study was to determine the aeroallergen sensitisation patterns of children aged 5 years and younger with asthma (AS) and/or allergic rhinitis (AR) in Istanbul, Turkey. MethodsThis cross-sectional observational study was conducted between January and December 2018 in the outpatient clinic of a hospital department of pediatric allergy. Patients, who had regular outpatient controls, full clinical and laboratory records, positive skin prick test results, and were willing to participate in the study, were included. ResultsIn total, 148 children aged 5 years or younger who had positive skin prick test results were included in the study. The male/female ratio and the mean age at onset of symptoms were 87/61 and 2.13±1.33 (0.4–4.5) years, respectively. Of the 148 patients, 63 (42.6%) had AS, 11 (7.4%) AR, and 74 (50.0%) had both AS and AR. The age of the patients, age at symptom onset, male/female ratio, number of allergen sensitivities, total IgE levels, total eosinophil levels, and skin prick test results for aeroallergens did not differ between the patients with AS, AR, and AS+AR. House dust mite (HDM) was the most common aeroallergen in patients, while the cockroach was the least common aeroallergen. The severity of asthma and control levels were not found to be associated with aeroallergen sensitisation in children. ConclusionOne out of every four atopic children aged 5 years or younger is sensitised to aeroallergens. The most common sensitisation is to house dust mites. Weed aeroallergen may be related to severity of asthma in children aged 5 years or younger in Istanbul. We speculate that HDM and weed allergens could be used in the diagnostic or treatment strategies for the management of asthmatic children aged 5 years or younger.

Oral Immunotherapy and Basophil and Mast Cell Reactivity in Food Allergy.

Basophil activation tests (BATs) can closely monitor, in vitro, a patient’s propensity to develop type I hypersensitivity reactions. Because of their high specificity and sensitivity, BATs have become promising diagnostic tools, especially in cases with equivocal clinical histories, skin prick test results, and/or levels of specific IgE to allergen extracts. BATs also are useful as tools for monitoring the effects of treatment, since oral immunotherapy (OIT) studies report a diminution in patients’ basophil responsiveness over the course of OIT. This review will discuss the BAT findings obtained before, during, and after OIT for food allergy. We will mainly focus on the association of basophil responsiveness, and alterations in basophil surface markers, with clinical outcomes and other clinical features, such as blood levels of specific IgG and IgE antibodies. The detailed analysis of these correlations will ultimately facilitate the use of BATs, along with other blood biomarkers, to differentiate short-term desensitization versus sustained unresponsiveness and to improve treatment protocols. Given the critical anatomic location of mast cells adjacent to the many IgE+ plasma cells found in the gastrointestinal tissues of allergic individuals, we will also discuss the role of gastrointestinal mast cells in manifestations of food allergies.

The most common allergens according to skin prick test: The role of wheal diameter in clinical relevancy.

The skin prick test (SPT) could be applied as a useful in vivo method for the detection of sensitization in epidemiological and diagnostic studies if the wheal size is ideally evaluated. We focused on SPT wheal size to identify sensitization pattern to common inhalant and food allergens. In this cross-sectional study, SPT results were obtained from a total of 972 allergic patients. Common allergen extracts for SPT were selected according to the type of allergic diseases, and the geographical pattern. SPT with food allergens was performed for patients with atopic dermatitis (AD) and chronic urticaria (CU). A total of 461 male (47.4%) and 511 female (52.6%) participated in this study (median age: 31 years). The majority of individuals were affected with allergic rhinitis (AR) (n = 624) and asthma (n = 224); while 129 and 67 patients suffered from AD and CU, respectively. The most common aeroallergens were Russian thistle (52.1%) and lamb's quarter (50.7%) with the largest wheal diameter. The wheal size of lamb's quarter was significantly different between patients with asthma and AR (P<.001). In addition, a significant difference was detected in wheal diameter in response to the Russian thistle between patients with AR and AD (P = .001). Shrimp (23.6%) and Peanut (22.5%) caused the most common food sensitization in patients with AD and CU. Having in mind the most common weed pollens including the Russian thistle and lamb's quarter, preventive strategies, such as, removing unwanted weeds or preventing them from growing, avoidance, and specific immunotherapy may be crucial for better disease control.

Allergy status in children with adenoid hypertrophy with and without serous otitis media

Introduction: Serous otitis media (SOM) is one of the most common diseases of children which can lead to hearing loss and imbalance in many cases. Objective: To evaluate the relationship between allergy status and SOM in children with adenoid hypertrophy and whether affected by age group. Materials and Methods: This cross-sectional study was conducted on 103 children aged 1-15 years with grade III or IV adenoid hypertrophy (± SOM) who referred to ear, nose, and throat (ENT) clinic. Additionally, children were divided into two subgroups based on age category of below and above seven years. The allergy status in children with and without SOM was compared by measuring the total immunoglobulin E (IgE) level, serum eosinophil level and skin prick test (SPT). Results: There was no difference in prevalence of mean absolute eosinophil count (127.3 versus 141.3 eosinophils/ µL, respectively) (P=0.63), mean total IgE level (68.2 versus 140 IU/L, respectively; P=0.119) and positive SPT results (23.5% versus 28.4%, respectively; P=0.551) between children with adenoid hypertrophy (± SOM). Conclusion: It seems absolute eosinophil count, total IgE level and positive SPT results have no significant role in SOM of children with adenoid hypertrophy and maybe other factors are implicated in its occurrence.

Association of Severity of Allergic Conjunctivitis with Skin Prick Test.

To investigate the association between skin prick test and severity of allergic conjunctivitis. Cross sectional observational study. Study Place and Duration of Study: Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad, between March and September 2019. 150 eyes of 150 diagnosed cases of allergic conjunctivitis, who had had a skin prick test, were included in the study. Cases with other concurrent ocular surface diseases, conjunctivitides, systemic allergies, and those on systemic steroids, anti-histamines and tricyclic antidepressant agents were excluded. Signs of allergic conjunctivitis were graded via slit-lamp examination using a 5-5-5 exacerbation grading scale. Allergic conjunctivitis was classified as being severe if the total score was ≥230, moderate if the score was >20 and <230, and mild if the score was ≤20. Frequency distribution was reported for age, gender and result of skin prick test. Test of significance and correlation analysis was carried out between the result of skin prick test and the severity of allergic conjunctivitis using Statistical Package for Social Sciences version 20.0. A p-value of <0.05 was taken as significant. Mean age was 18.62 (±8.15) years in 91 males and 59 females. Mild (n = 28), moderate (n = 77), and severe (n = 45) cases showed no statistically significant correlation with the skin prick test (positive or negative) in any of the three categories (mild p = 0.44, r = 0.153, moderate p = 0.89, r = 0.016, and severe p = 0.73, r = 0.052). Skin prick test did not show a significant association or correlation with the severity of allergic conjunctivitis. Key Words: Allergic conjunctivitis, Hypersensitivity, Skin prick test.

Correlation of skin prick testing to environmental allergens

BackgroundTo diagnose and adequately treat allergies, identification of sensitizing allergens is crucial. Skin prick or serum immunoglobulin E testing determines sensitization to potential allergens. Consensus varies regarding degree of cross-reactivity between aeroallergens. ObjectiveTo quantify correlations between aeroallergen skin prick test results. MethodsA total of 11,832 patients’ quantitative skin prick test results and basic characteristics were obtained from a tertiary academic center’s electronic medical record and deidentified. Data were analyzed using Spearman’s rank correlation coefficients to detect nonlinear associations between wheal sizes of skin prick test results. ResultsThe highest correlation among grasses was 0.903 (fescue and red top). Of note, 13 more grass pairs had correlation more than 0.8, and 19 had correlation between 0.7 and 0.8. The Northern grass comparative results are from a satellite clinic that tested more grasses than the main clinic, in which only Kentucky blue and Bermuda were tested (correlation 0.768; n = 9348). Highest correlation among weeds was 0.74 (lambs quarter and pigweed). In addition, 6 more weed pairs had correlation more than 0.7. Highest correlation among trees was 0.724 (palm and alder) and 6 more tree pairs had correlation more than 0.7. Highest correlation among molds was 0.711 (Helminthosporium and Epicoccum). Dust mite correlation between Dermatophagoides farinae and Dermatophagoides pteronyssinus was 0.848 (n = 10,022). ConclusionThis study confirmed the expected high degrees of correlation not only between skin prick test results of related environmental allergens but also between less closely related Northern grasses and Bermuda grass. This has implications for simplification of testing and immunotherapy protocols in the future.

Airborne fungal spore relationships with meteorological parameters and skin prick test results in Elazig, Turkey.

Since fungi spores have high concentrations in the atmosphere during most of the year, they have an important place in respiratory allergies. In this regard, the preparation of calendars showing fungi spore loads for residential areas has much importance in the treatment of the patients. The first aim of this study was to present the airborne fungal spore research results from Eastern Anatolia in Turkey. Then, the mold spores' relationships with the meteorological parameters and skin prick test results were also evaluated. The presence of fungal spores was investigated using a volumetric spore trap in 2018year. In this study, fungal spores within the atmosphere of the Elazığ city of Turkey was measured through the volumetric method, using a Lanzoni VPPS 2000 device (VPPS 2000 Lanzoni, Bologna, Italy), in 2018year. Annual data of temperature, humidity, precipitation and wind speed were used for comparing meteorological data with airborne fungal spore counts. In addition, 637 children who were admitted to a pediatric allergy clinic with allergic complaints were enrolled in the study. A total of 145,099 spores/m3 and 20 fungal taxa belonging to the molds were recorded. Ustilago was the predominant genus (18.10%), followed by Oidium (18.01%), Drechslera (12.82%), and Fusarium (11.60%), which were the most common fungal spores found in Elazig's atmosphere. The total mold spores in the atmosphere reached the highest level, with 28,153 spores/m3, in July (mid-summer). Moreover, we found a positive correlation between the mold spores and the temperature, but negative correlations with the humidity and wind speed. In the skin prick tests in the children with allergic complaints, we detected sensitization to Alternaria alternata in 4.4%, Cladosporium herbarum in 3.0%, Penicillium notatum in 1.4%, and Aspergillus fumigatus in 1.1%. Additionally, there was no correlation between fungal spore concentration in the atmosphere with fungal spores sensitization in the skin prick test. This study was the first aerofungal survey of the Eastern Anatolia region in Turkey; therefore, new information has been introduced in the field of aerobiology in Turkey.

Comparison between Specific Immunoglobulin E and Skin Prick Test for Diagnosis of Allergic Patients

Background: Skin prick test (SPT) has been identified as the gold standard method to diagnose IgE mediated hypersensitivities; it is accurate, easy and cheap. However, SPT has some important limitations, so in vitro serum specific serum IgE (sSIgE) detection can be a good alternative. The diagnostic yield of sSIgE testing usually depends on the specific allergen. Objective: This study compares between SPT and sSIgE for diagnosis of allergy. Methodology: 61 allergic patients enrolled from Zagazig University Allergy and Immunology Unit, tested by SPT for the common allergens. Serum total IgE and specific IgE levels were measured and compared to SPT results. Results: The over- all sensitivities of sSIgE were excellent (75-100%) for most of allergens tested. PPV was excellent with some allergens (pollens, cockroaches, mites) and poor with others (cat hair). Sensitivity of mites sSIgE was excellent with PPV approaching 90%, specificiy was only 13%. However, the NPV was 100%. Significant level of agreement and correlation between the results of SPT and sSIgE for cockroaches and molds was reported. Positive correlation between the total levels of serum IgE and the diameter of wheal and flare of the SPT for mites, pollens and cockroaches was found. Conclusion: The sensitivities of sSIgE were excellent for most of allergens tested. Specificity of sSIgE varies between individual allergens. Serum specific IgE testing may be a good alternative to skin prick test if the latter could not be carried out.