Comparison of the Performance of Skin Prick, ImmunoCAP, and ISAC Tests in the Diagnosis of Patients with Allergy
| Autor: | Tariq El-Shanawany, Stephen Jolles, Rebecca L M Griffiths, Paul Williams, Emily Carne, Adrian Heaps, C. Selwood |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Allergy Immunology Immunologic Tests medicine.disease_cause Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Allergen Oral allergy syndrome medicine Humans Immunology and Allergy In patient business.industry General Medicine medicine.disease 030104 developmental biology 030228 respiratory system Latex allergy Female Case note business Food Hypersensitivity Anaphylaxis Wheat allergy |
| Zdroj: | International Archives of Allergy and Immunology. 172:215-223 |
| ISSN: | 1423-0097 1018-2438 |
| DOI: | 10.1159/000464326 |
| Popis: | Background: Allergy is diagnosed from typical symptoms, and tests are performed to incriminate the suspected precipitant. Skin prick tests (SPTs) are commonly performed, inexpensive, and give immediate results. Laboratory tests (ImmunoCAP) for serum allergen-specific IgE antibodies are usually performed more selectively. The immuno-solid phase allergen chip (ISAC) enables testing for specific IgE against multiple allergen components in a multiplex assay. Methods: We retrospectively analysed clinic letters, case notes, and laboratory results of 118 patients attending the National Adult Allergy Service at the University Hospital of Wales who presented diagnostic difficulty, to evaluate which testing strategy (SPT, ImmunoCAP, or ISAC) was the most appropriate to use to confirm the diagnosis in these complex patients, evaluated in a “real-life” clinical service setting. Results: In patients with nut allergy, the detection rates of SPTs (56%) and ISAC (65%) were lower than those of ImmunoCAP (71%). ISAC had a higher detection rate (88%) than ImmunoCAP (69%) or SPT (33%) in the diagnosis of oral allergy syndrome. ImmunoCAP test results identified all 9 patients with anaphylaxis due to wheat allergy (100%), whereas ISAC was positive in only 6 of these 9 (67%). Conclusions: In this difficult diagnostic group, the ImmunoCAP test should be the preferred single test for possible allergy to nuts, wheat, other specific foods, and anaphylaxis of any cause. In these conditions, SPT and ISAC tests give comparable results. The most useful single test for oral allergy syndrome is ISAC, and SPT should be the preferred test for latex allergy. |
| Databáze: | OpenAIRE |
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