Neue Charakteristika klinisch manifester Latexallergiker

2019 ◽  
Vol 7 (1) ◽  
pp. 29-31
Author(s):  
Vera Mahler
Keyword(s):  
Medical History ◽  
Skin Test ◽  
Correct Diagnosis ◽  
Natural Rubber Latex ◽  
Specific Ige ◽  
Latex Allergy ◽  
Skin Tests ◽  
Diagnostic Challenge ◽  
Positive Skin ◽  
Significant Difference

Background: Natural rubber latex (NRL) allergy is commonly diagnosed according to medical history, skin allergy tests, and serological analyses. However, skin tests are increasingly being abandoned because of (i) their time-consuming nature, (ii) latex preparations for skin tests being not commercially available, and (iii) the use of in-house prepared test solutions is becoming ever more difficult due to increasing regulatory hurdles. In this light, we have evaluated differences in the profiles of current and former patients with suspected latex allergy. Methods: Sera of skin test-positive patients from a historic cohort (1995-2001, n = 149 patients) and currently (2014-2015, n = 48 patients) were simultaneously analyzed for specific IgE to latex by ImmunoCAP. If the serological screening was positive (≥ 0.35 kU/l), component-resolved diagnostics including profilins and cross-reactive carbohydrate determinants (CCDs) were performed. Results: In contrast to 88% (131/149) of the skin test-positive patients from the 1990s, only 51.1% (24/47) of the current cohort were found positive for specific IgE to latex. While 48.3% (72/149) of the patients had a convincing positive history in the 1990s, current skin test-positive patients rarely reported a relevant medical history (8.5%, 4/47). Specific IgE levels to latex were significantly higher in former patients with suspected latex allergy (p < 0.001) than in former sensitized individuals without allergy. However, this significant difference was lost in current allergic and sensitized patients with positive skin tests. Conclusion: Sensitization profiles in patients with latex allergy have changed significantly over the last 2 decades. Discrimination between NRL sensitization and clinical allergy remains a diagnostic challenge. Our data highlight the need for a combination of all 3 criteria, i.e., patient history, skin test, and analysis of specific IgE, for a correct diagnosis of latex allergy.

Significance of Borderline Levels of Specific IgE obtained by FAST-Plus Assay

1992 ◽  
Vol 106 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Richard L. Mabry ◽  
Cynthia S. Mabry
Keyword(s):  
Skin Test ◽  
Specific Ige ◽  
Skin Tests ◽  
In Vitro Assays ◽  
Test Results ◽  
Positive Skin ◽  
Glycerine Concentration ◽  
Current Standards

The significance of “borderline” levels of allergen-specific IgE as measured by in vitro assays has been questioned. Patients whose specific IgE tests Patients were tested for twelve antigens using the FAST-Plus methodology. All 0/1 results were checked using skin tests at a 1:500 concentration. Positive (histamine) and negative (diluent) controls were used. The antigen-induced wheals were compared with those produced by a control wheal of 2% glycerine (the glycerine concentration in a 1:500 dilution). Positive wheals were arbitrarily considered to be those whose diameter after 10 minutes exceeded that of the glycerine control wheal by 2 mm or more. Using the limits of calibrator fluorescence for the FAST-Plus test in effect before 1990, a significant discordance between skin test results and the class 0/1 in vitro readings was evident. Using the standards in effect since 1990, marked concordance between class 0/1 results and positive skin tests was noted. This was most marked for pollens, less so for molds. Using current standards, FAST-Plus class 0/1 results are best considered positive (pending clinical confirmation), rather than negative.

Penicillin Hypersensitivity

1979 ◽  
Vol 1 (5) ◽  
pp. 132-158
Keyword(s):  
Skin Test ◽  
Multicenter Study ◽  
Positive Skin Test ◽  
Penicillin Allergy ◽  
Skin Tests ◽  
Penicillin G ◽  
Positive Skin ◽  
Positive History ◽  
History Of

A (massive) multicenter study of 3,000 patients has demonstrated that skin tests to penicillin G and penicilloyl-polylysine (PPL-now commercially available) predict and confirm penicillin allergy. Of patients with a history of penicillin reaction, 19% were positive to either, compared to 7% of controls. A history of anaphylaxis led to 46% positive. Of those with a history of urticaria 17% were positive, and those with maculopapular eruptions did not differ from controls (7% positive). Challenge with penicillin led to a reaction in 6% with a positive history (compared to 2% with a negative) and 67% with a combined positive history and positive skin test (to either).

Meglumine antimoniate-induced DRESS: original case with a positive skin test

2018 ◽  
Vol 63 (4) ◽  
pp. 845-847 ◽  
Author(s):  
Amel Chaabane ◽  
Haifa Ben Romdhane ◽  
Hajer Ben Brahim ◽  
Nadia Ben Fredj ◽  
Zohra Chadli ◽  
...  
Keyword(s):  
Skin Test ◽  
Clinical Picture ◽  
Drug Withdrawal ◽  
Skin Tests ◽  
Positive Skin ◽  
Meglumine Antimoniate ◽  
Blood Tests ◽  
Intradermal Tests ◽  
Original Case ◽  
Hepatic Cytolysis

Abstract We report a case of a 64-year-old woman treated with meglumine antimoniate (Glucantime®). On day 20, she developed fever, a pruriginous skin rash and myalgia. The blood tests showed eosinophilia and hepatic cytolysis. The clinico-biological picture improved gradually and the symptoms disappeared 4 weeks after the drug withdrawal. Six weeks later, intradermal tests to Glucantime® were performed and were positive at 48 hour-reading. This clinical picture suggests DRESS induced by meglumine antimoniate. To the best of our knowledge, only one case of meglumine antimoniate-induced DRESS has been reported in the literature and we are the first to report a case confirmed by skin tests.

THE CUTANEOUS REACTION TO EGGWHITE

PEDIATRICS ◽  
1959 ◽  
Vol 24 (6) ◽  
pp. 1009-1015
Author(s):  
Richard L. London ◽  
Jerome Glaser
Keyword(s):  
Skin Test ◽  
Skin Testing ◽  
Intradermal Test ◽  
Skin Tests ◽  
Etiologic Factor ◽  
Initial Reaction ◽  
Age Group ◽  
Positive Skin ◽  
Clinical Sensitivity ◽  
Number Of Patients

A study of 400 allergic patients of all ages, who were skin tested with eggwhite, is reported. The authors agree with those who believe that a positive reaction in infants who have in no known way been exposed to eggwhite after birth is in all probability due to intrauterine sensitization. There is a possibility, however, that some reactions to eggwhite may be due to a primary histamine or serotonin releasing substance present in the eggwhite which has no relationship to antigen-antibody reaction. The circumstances under which this takes place are not known. In all age groups the family history was positive in about 65% of cases. It was surprising to find, in view of previous opinions, that in the youngest age group (infants up to 2 years of age), the skin test was positive in less than half the patients (42%) in the presence of clinical sensitivity. It was also unexpected to find that the number of patients clinically sensitive to eggwhite but giving negative skin tests increased as age advanced. This justifies the common practice of eliminating egg as a trial measure in the diet of the first age group, regardless of the results of skin testing, and suggests that this should be done in any age group where food is considered a possible etiologic factor. In the youngest age group somewhat more than one-third (34%) of the patients reacted positively to eggwhite but were not clinically sensitive. This finding was completely unexpected as it had been thought that in this age group a positive skin test to eggwhite was practically pathognomonic of clinical sensitivity. In this study more positive reactions in children to eggwhite were obtained (70.5%) than in a somewhat comparable series where the incidence was much less (20%). We attribute this to the fact that in our series both scratch and intradermal tests were made while in the other series only scratch tests were done. This reflects the greater sensitivity of the intradermal test. Only about half the patients of all ages who react to eggwhite are also clinically sensitive. Attention is drawn to a theory which explains why a positive cutaneous test to a food, as eggwhite, may be clinically significant in atopic dermatitis even though the test (wheal reaction) does not reproduce the type of dermatitis being studied. There was no definite evidence, because the number of cases studied is far too small, to indicate that the severity of asthma which may ultimately develop in infants not asthmatic at the time of skin testing is proportional to the strength of the initial reaction to eggwhite.

Successful Desensitization to Cetuximab in a Patient With a Positive Skin Test to Cetuximab and Specific IgE to Alpha-gal

2016 ◽  
Vol 26 (2) ◽  
pp. 132-134 ◽  
Author(s):  
JM García-Menaya ◽  
C Cordobés-Durán ◽  
J Gómez-Ulla ◽  
MA Zambonino ◽  
AC Mahecha ◽  
...  
Keyword(s):  
Skin Test ◽  
Specific Ige ◽  
Positive Skin Test ◽  
Positive Skin

Positive Skin Test or Specific IgE to Penicillin Does Not Reliably Predict Penicillin Allergy

2017 ◽  
Vol 5 (3) ◽  
pp. 676-683 ◽  
Author(s):  
Line Kring Tannert ◽  
Charlotte Gotthard Mortz ◽  
Per Stahl Skov ◽  
Carsten Bindslev-Jensen
Keyword(s):  
Skin Test ◽  
Specific Ige ◽  
Positive Skin Test ◽  
Penicillin Allergy ◽  
Positive Skin

scholarly journals The skin test with tuberculous recombinant allergen AT successful treated patients with lung tuberculosis

2018 ◽  
Vol 20 (3) ◽  
pp. 17-20
Author(s):  
G S Balasanyants ◽  
N V Skotnikova ◽  
V V Dantsev
Keyword(s):  
Skin Test ◽  
Dynamic Control ◽  
Skin Tests ◽  
Recombinant Allergen ◽  
Positive Skin ◽  
Group 13 ◽  
Group Iii ◽  
Lung Tuberculosis ◽  
Skin Response ◽  
The Moment

38 patients with newly diagnosed tuberculosis, immediately after the end of the main course of treatment, when they were transferred to the third group of dispensary supervision (6-9 months) and when they were removed from the dispensary supervision (2-3 years later), a skin test with an allergen tuberculous recombinant was made. The positive skin test with tuberculosis recombinant allergen was defined at 20 patients - 13 mm. At the moment of removing to the III group only one skin test with tuberculosis allergen recombinant became negative, 19 (94,5%) patients had positive reactions - 13±2,3 mm. At the time of discharging from dispensary the positive reactions were determined at 16 (80%) cases - 10±2,3 mm, p0,05. In this group, 13 (65%) patients had normergic skin tests with tuberculosis allergen recombinant and 7 (35%) - hyperergic tests. At the time of removing to the III group at five from seven patients with hyperergic tests the results remained the same, median and at the moment of discharging from tuberculosis service only one patient had the hyperergic skin test with tuberculosis allergen recombinant - 18mm. Among patients with normergic skin tests with tuberculosis allergen recombinant at the time of group III removing median was 11±2,1 mm. At the last dynamic control the normergic results were determined at 15 (75%) patients and the tests median remained almost unchanged - 10±1,8 mm, the differences are reliable compared to the initial data (p0,05). In group which included 18 patients with negative skin tests with tuberculous allergen recombinant, the skin response stayed negative throughout all examination period except for one patient so patients of this group had not only clinical, radiological and bacteriological, but immunological signs of involution of the tuberculosis process. The study of the influence of clinical, epidemic and social factors to skin reaction showed that first group patients were significantly more likely to be unemployed (30% versus 5,5%; p0,05) whereas in second group married patients were reliably registered (61,1% versus 25%; p0,05). Other factors differed unreliably.

scholarly journals Evaluation of a New Routine Diagnostic Test for Immunoglobulin E Sensitization to Neuromuscular Blocking Agents

2011 ◽  
Vol 114 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Dominique Laroche ◽  
Sylvie Chollet-Martin ◽  
Pierre Léturgie ◽  
Laure Malzac ◽  
Marie-Claude Vergnaud ◽  
...  
Keyword(s):  
Skin Test ◽  
Quaternary Ammonium ◽  
Immunoglobulin E ◽  
Solid Phase ◽  
Specific Ige ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity

Background Neuromuscular blocking agents (NMBA) are responsible for most immediate hypersensitivity reactions during anesthesia, as a result of the presence of a quaternary ammonium ion. The aim of this study was to evaluate the diagnostic performance of a commercial immunoglobulin E (IgE) test (quaternary ammonium morphine [QAM]) for diagnosing sensitivity to NMBA. Methods We tested 168 patients exposed to NMBAs during anesthesia. Of those patients, 54 had an uneventful procedure and 114 had immediate hypersensitivity reactions, and 57 patients had positive skin tests to the administered NMBA, whereas 57 had negative skin tests. Specific IgE concentrations determined with the QAM method based on a morphine solid phase were compared with those obtained with a recommended experimental method with a choline solid phase. Results For the QAM test, a 0.35 kUA/l positivity cutoff was chosen from the receiver operating characteristics curve. QAM-specific IgE was found in 84.2% of skin test-positive reactors (80.7% with the recommended method; no significant difference), and binding was inhibited by the culprit NMBA in 80% of cases. The frequency of QAM-specific IgE positivity was significantly higher in skin test-negative reactors (24.6%) than in controls (9.3%), suggesting NMBA sensitivity. Conclusion Sensitivity of the QAM test (84.2%), together with its simplicity and suitability for routine laboratory use, makes it a valuable tool, in conjunction with skin tests, for diagnosing NMBA sensitivity in patients who react after NMBA injection. The QAM test is of particular interest when skin tests are not available or not reliable or give results poorly compatible with mediator release or clinical features.

Sign in / Sign up

Export Citation Format

Share Document