Correlation of Skin Test Results and Specific Immunoglobulin E Blood Levels with Nasal Provocation Testing for House-Dust Mite Allergies
| Autor: | Tilman Huppertz, Kai Fruth, Florian Bast, Boris R. Haxel, Patrick Boessert |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Allergy Dermatophagoides pteronyssinus medicine.medical_treatment Provocation test Nasal provocation test Young Adult 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Hypersensitivity medicine Mite Animals Humans Immunology and Allergy Antigens Dermatophagoides 030223 otorhinolaryngology Sensitization Retrospective Studies Skin Tests Desensitization (medicine) House dust mite Dermatophagoides farinae biology business.industry General Medicine Immunoglobulin E Middle Aged medicine.disease biology.organism_classification medicine.anatomical_structure 030228 respiratory system Otorhinolaryngology Desensitization Immunologic Predictive value of tests Immunology Female Immunization business |
| Zdroj: | American Journal of Rhinology & Allergy. 30:60-64 |
| ISSN: | 1945-8932 1945-8924 |
| Popis: | Background Allergen-specific immunotherapy for house-dust mite (HDM) allergies is associated with lower success rates when compared with similar treatments for other inhalant allergens, such as grass or birch. One reason might be the greater difficulty in diagnosing patients with assumed HDM allergies because symptoms occur perennially and may differ from those of a conventional allergic rhinitis. Objective The aim of the study was to compare the different methods of diagnosis in patients with assumed HDM allergy. Methods We performed a retrospective analysis of nasal provocation tests (NPT) from patients (n = 161) evaluated for Dermatophagoides pteronyssinus (n = 127) and Dermatophagoides farinae (n = 104) allergies, and compared the results with other allergen testing methods (skin-prick test [SPT], intracutaneous test, and allergen specific immunoglobulin E levels [sIgE] to detect sensitization). Receiver operating characteristic curves were used for the analyses and the areas under the curve were calculated. Results For D. pteronyssinus and D. farinae, 86 and 70 complete data files, respectively, were available. For both tested HDMs, the results of the receiver operating characteristic curves showed a significant correlation for SPT and sIgE, with the results of the NPT (area under the curve, 0.742 to 0.763) but not for the intracutaneous test. In patients with a positive SPT (≤3 mm), an allergy was confirmed by the NPT in 69% of cases for D. pteronyssinus and 71% for D. farinae. A positive sIgE result (ImmunoCAP class of ≤2) was verified by the NPT in 69% of cases (D. pteronyssinus) and 70% (D. farinae). Conclusion The predictability value for a positive NPT result is best for SPT and sIgE. Nevertheless, even if the results of both test systems are combined, the positive predictive value that was achieved was only 0.77 for D. pteronyssinus and 0.69 for D. farinae. Therefore, in patients eligible for immunotherapy for HDM, an NPT should be performed before the start of the therapy to verify a clinically relevant allergy. |
| Databáze: | OpenAIRE |
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