Skin Test Data Research Articles

ACUTE HYPERSENSITIVITY TO INGESTED PROCESSED POLLEN

Ingestion of commercially processed honeybee-collected pollen produced potentially fatal consequences in a 19 year old asthmatic male. Symptoms of sore throat, facial itch and swelling, difficulty in breathing and stridor lasted for approximately two hours and was followed by clinical respiratory distress with widespread wheeze on auscultation of his chest. RAST and skin test data suggest that these complications appear to be mediated by IgE antibodies directed against the processed pollen, but not bee venom. Consumption of processed pollen by atopic individuals is, therefore, a potentially hazardous procedure with little therapeutic benefit.

Evaluation of immediate adverse reactions to foods in adult patients: I. Correlation of demographic, laboratory, and prick skin test data with response to controlled oral food challenge

Forty-five adult patients, referred to here as the index population, with a history of immediate adverse reactions after food ingestion were evaluated by history, physical examination, laboratory studies, and skin testing. Fifty-six percent of these patients reported adverse reactions to only one food, whereas 84% of the patients reported up to three foods as being capable of eliciting reactions. The average age obtained by history at which adverse reactions began to occur was 19 4 5 yr. The occurrence of these reactions persisted over an average of 14 4 5 yr. Most reactions involved the gastrointestinal tract alone or in combination with the skin or respiratory tract. The most frequently involved foods were shellfish, peanuts, eggs, fish, tomatoes, and walnuts. Twenty-five of the patients participated in oral challenge with the suspected food. The food challenge was positive in 10 patients. Comparison of information obtained by history including personal or family history of any other allergic disease, age of onset of sensitivity, the length of time of suspected sensitivity in years, and the number of foods to which the sensitivity was believed to exist revealed no significant differences between food challenge-positive (FC+) and food challenge-negative (FC−) patients. However, a significant difference in the reaction patterns reported by history in the FC+ and FC− patients was noted in that FC + patients more often described reactions in which a combination of gastrointestinal, respiratory, and dermatologic symptoms occurred. The complete blood count with differential, blood chemistries, and serum immunoglobulin levels were similar in both groups. Nine of 10 patients in the FC+ group had positive skin tests to the food that produced clinical symptoms. The skin tests were positive to a suspected food in three of the 15 patients in the FC− group. The results obtained suggest that an immediate adverse reaction to a food may have its initial presentation when the patient has reached adulthood, that such individuals tend to be atopic, that three or fewer foods are generally implicated, and that such sensitivities may persist for years. Patients who describe previous reactions involving combined gastrointestinal, respiratory, and dermatologic symptoms and have a positive skin test to the suspected food are more likely to experience a reaction on subsequent exposure to that food.

Infectious disease patterns in the Waorani, an isolated Amerindian population.

The Waorani Indians of eastern Ecuador provide a unique opportunity for studying exposure of an isolated human population to various infectious disease agents. Using serologic tests to determine antibody prevalence, skin test data, and stool examination for parasites, we have been able to construct a profile of infectious diseases which are endemic, and others which have been introduced into the Waorani population. These findings are compared with similar data reported from elsewhere in the Amazon. Serologic studies demonstrating the presence of antibody to measles and poliovirus type 3 after vaccination indicate that the Waorani respond normally to viral challenge with these agents. The question of genetic inability among aboriginal Amerindians to respond to viral agents is discussed. Finally, general recommendations are made regarding the future health care of the Waorani.

Correlations between clinical, blood leukocyte, and skin test data in the National Cooperative Crohn's Disease Study

Peripheral blood leukocyte counts, percentages of lymphocytes and granulocytes, serum albumin levels, and results of skin tests with five antigens were examined in patients randomized in the National Cooperative Crohn's Disease Study. Inspection for differences from normal and correlations with a variety of variables showed no unusual characteristics except for a high incidence of anergy (31%) at randomization, and ranging up to 47.5% after treatment.

Immunological skin testing and interpretation. A plea for uniformity

Immunological skin tests are one of the major methods used for the assessment of one's immune status. A review of the literature clearly reveals that there is no uniform methods for the administration and interpretation of skin tests. Without uniformity, it is obvious that data are not comparable. Contradictory conclusions may be reached from the same skin test data, depending upon the method of interpretation used. Precedent, rather than rationale, has often determined the method of interpretation. There are studies which suggest that slight induration or erythema, often considered negative, are significant immunologic events. The various methods of skin test administration and interpretation are reviewed. Recommendations for application and interpretation are presented so that uniformity may exist.

Epithelioid granulomas associated with Hodgkin's disease: clinical correlations in 55 previously untreated patients.

Non-caseating sarcoid-like epithelioid granulomas associated with Hodgkin's disease have been found in 55 patients initially staged and treated at the Stanford University School of Medicine. These patients are compared to 553 concurrent patients not having granulomas associated with their Hodgkin's disease. Pre-treatment parameters of the two groups are presented and found not to be different. Patterns of relapse in granuloma patients are presented and no relationship between location of granulomas and subsequent relapse is found. Survival and relapse-free survival curves are significantly different in favor of the granuloma group (p = 0.005 and p = 0.03, respectively). Correlation with skin test data has been attempted using a matched control analysis and no difference is found in reaction to intradermal antigens between the two groups.

Skin testing for prognosis or therapy formulation in cancer patients: caveat emptor.

Delayed cutaneous hypersensitivity to DNCB was assessed in 56 patients who had epidermoid intraoral carcinoma, prior to therapy. They were followed for 44 months, and their skin reactivity correlated well with both a small tumor size and a favorable clinical prognosis. In a significant number of cases, however, lack of reactivity did not indicate a fatal outcome. Therefore, we recommend caution in the use of any skin test data in formulating therapy. When cured cancer patients were skin-tested, there was no correlation between the state of the disease and their skin reactivity.

Immunity to antigens associated with a cell line derived from nasopharyngeal cancer (NPC) in non‐Chinese NPC patients

Delayed hypersensibility to antigens derived from four lymphoid cell lines was measured in 27 non-Chinese patients with nasopharyngeal cancer (NPC) and 63 non-NPC cancer patients. Of the NPC patients, 17/27 (63%) had a positive skin test response to antigens derived from HKLY-28, a lymphoid cell line which was developed from an NPC biopsy. Only 10/51 (20%) and 1/13 (8%) patients with solid tumors and hematopoietic malignancies, respectively, had positive skin test responses to HKLY-28. Positive skin tests were found less frequently when extracts from cell lines derived from normal individuals or lymphoma patients were utilized, although NPC patients were more reactive to two of the non-NPC derived cell lines than the controls. The NPC patients in this study also had significantly elevated antibody titers to the Epstein-Barr virus (EBV), capsid antigen (VCA) and early antigen (EA). Titers were highest in the patients with more anaplastic nasopharyngeal carcinomas. The skin test and serologic data are consistent with studies in Chinese patients, indicating that NPC in non-Chinese and Chinese patients is biologically similar.

Infectivity of sputum-positive tuberculous patients on chemotherapy.

A retrospective study was undertaken to assess infectivity for household contacts of tuberculous patients briefly hospitalized in a private general hospital and discharged receiving ambulatory chemotherapy while sputum still contained tubercle bacilli. Eighty-six patients (Group A) were discharged for supervised home therapy while culture positive (52 were positive by smear), and 69 patients (Group B) were negative by both smear and culture at discharge. The median hospital stay was less than 6 weeks, and the median time for culture conversion to negative after discharge for Group A was 41 days. Risk of infection for 284 Group A contacts and for 216 Group B contacts was assessed by skin testing performed before discharge of the index case, or 3 months after the index case became culture negative, or both. Brief hospitalization required skin test data to be analyzed according to the total number of reactors among each group of contacts. When induration of more than either 5 or 9 mm were considered positive...

Influence of the intestinal flora on the development of immune reactions in infants.

Breast-fed and artifically fed infants are in contact with the O antigen of Escherichia coli from the first days after birth. From the mother, the infant obtains antibodies against nonpathogenic E. coli strains in low titer, and the infant begins to form its own antibodies during the 2nd month of life. The transition is known to be continuous even though the transferred antibodies could not be differentiated from the infant's own antibodies. Contact with endotoxin caused sensitization which was detected by the skin test at about 2.5 months, and thereafter the skin test data correlated with the presence of serum antibodies against endotoxin. The newborn infant can be colonized with a different E. coli serotype; such an antigenic stimulus evokes the formation of antibodies sooner and at a significantly higher titer than (i) the level of maternal antibodies transferred or (ii) the infant's antibodies normally formed later on against other random E. coli serotypes.

Cat scratch disease: results of complement-fixation and skin tests.

Abstract : Serologic and skin-testing data on a group of patients having cat scratch disease are presented to demonstrate a possible relationship to the psitt-LGV group of viruses. In addition, the results of skin-testing patients with different batches of skin-test antigen are given. The data obtained indicate that the incidence of positive serologic reactions with the psitt-LGV group antigen is consistently higher in patients with cat scratch disease than in individuals of the control group. However, the percentage of positive reactions is not what would be expected from any direct etiologic casual relationship. The response of groups of individuals of different preparations of skin-testing antigen was so variable as to suggest that either more than one agent may be involved or marked strain variations must occur among the agents producing this clinical syndrome. In a small series of LGV patients, 2 of 5 did not respond with positive skin reactions when tested with cat scratch antigen, and at least 2 of the remaining 3 responded in a manner difficult to interpret.