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The relative value of skin tests and radioallergosorbent test in the diagnosis of bee sting hypersensitivity.

The relative diagnostic value of ST and RAST was evaluated in 97 patients with BSH. Eighteen patients had LRs, 79 showed SRs including 18 with urticaria, 26 had bronchospasm, and 35 had anaphylactic shock. ST but not the RAST reactivity was strongly related to the severity of the clinical reaction (p less than or equal to 0.001) and found superior to the RAST in identifying patients with SRs in whom venom therapy was indicated.

Aging↗

Diagnosis of reaginic allergy with house dust, animal dander and pollen allergens in adult patients. III. Case histories and combinations of case histories, skin tests and the radioallergosorbent test, RAST, compared with provocation tests.

Case histories alone and combined with the results of skin tests and/or the radioallergosorbent test (RAST) were compared with the results of provocation tests in 397 patients with asthma or allergic rhinitis. Case histories often turned out to be doubtful. The agreement between negative histories and negative provocation tests was 77% and that between positive histories and positive provocation tests 64%. When case histories were supported by concordant skin test or RAST results, the agreement with provocation tests increased to about 90%. When a scoring system for the combinations of different diagnostic methods was employed, a 100% agreement with provocation tests was obtained for cases with high scores. It is concluded that by using the case history in conjunction with RAST and/or skin test results, a reliable diagnosis can be achieved, eliminating the necessity of provocation tests.

Allergens↗

Allergy to insect stings. IV. Diagnosis by radioallergosorbent test (R.A.S.T.).

Radioallergosorbent tests (RAST(s)) have been developed and assessed for the diagnosis of insect hypersensitivity by using a purified allergen from honeybee venom, phospholipase A, and crude yellow jacket venom. Sera from 193 patients positive both by history and skin test to one of these insects were compared with various groups of control sera. Eighty percent of sera from skin test-positive patients were RAST positive; positive RAST were found in 16% of sera tested from skin test-negative patients. A highly positive RAST correlates well with a positive skin test and clinical sensitivity, but serum IgE is not measurable in many patients with mast cell or basophil bound antibody. Since biologically important reactions of antigen with IgE require that the antibody be cell bound, skin testing would be preferred to RAST if one were limited to a single test for the diagnosis of insect allergy.

Animals↗

Total serum IgE, allergy skin testing, and the radioallergosorbent test for the diagnosis of allergy in asthmatic children.

Correlations of total serum IgE, skin test reactivity, and specific IgE antibodies to selected antigens were evaluated in asthmatic children. There was a significant difference in mean IgE level of each positive RAST score group compared with that of the RAST-negative score for dog epithelium, Candida, ragweed, and Bermuda grass allergen. The correlation coefficient between the total IgE and the RAST to D. farinae was 0.39 (P less than .05). There was no significant correlation between the total IgE and the RAST to D. pteronyssinus, Candida, dog epithelium, ragweed, Eucalyptus pollen, and Bermuda grass (P greater than .05). This indicates a low total serum IgE concentration does not exclude the possibility of significant elevation of specific IgE to a common allergen. Concordance for results of intradermal skin testing and RAST was high for most allergens. Lower efficiency for dog allergen and Candida suggests greater sensitivity of allergy skin testing for these allergens.

Adolescent↗

Diagnosis of food allergy by the radioallergosorbent test.

The radioallergosorbent test (RAST) was positive in 52.5% of 200 sera representing 200 food hypersensitivities from 108 patients with a history of definite immediate-type reactions to foods. Corresponding prick test was performed for 170 of the sera. The latter test was positive in 70%, the RAST was positive in 52%, and iether prick test or RAST was positive in 74%. It is concluded that the RAST is positive less frequently than the prick test in the diagnosis of immediate-type food allergy in clinically sensitive patients, but that the performance of both tests increases slightly the possibility of confirming the diagnosis. However, the RAST is useful for further evaluating positive prick tests with foods that do not correlate with clinical hypersensitivity.

Eggs↗

The diagnosis of hypersensitivity to ingested foods. Reliability of skin prick testing and the radioallergosorbent test with different materials.

The diagnostic reliability in food allergy of skin prick tests (SPT) and the radio-allergosorbent test (RAST) was investigated in paediatric patients with respiratory and skin allergies. SPT and RAST were found to be reliable for the diagnosis of allergy to codfish, peas, nuts, peanuts and egg white. Positive SPT and RAST to cereals were common, but were most often without clinical significance or were correlated with respiratory allergy to the inhalation of flour dust. SPT and RAST were only partly reliable with regard to allergy to cow's milk, and were mostly reliable when used together and showing corresponding results. Experimental allergosorbents for RAST with soy beans and white beans were not reliable. The study shows the need to improve the diagnostic materials and to establish the diagnostic reliability of the material and tests used for each food item in question.

Adolescent↗

Correlation of the modified scratch test with the radioallergosorbent test (RAST) in atopic children.

The usefulness of the modified scratch test in predicting clinical allergy and its correlation with the RAST were studied in 83 atopic children. A total of 423 scratch tests were compared with the same number of RAST. Percentage agreements between the two tests for individual allergens ranged from 87.5% (milk) to 50% (cat epithelium). The RAST showed more positive results only for the house dust allergen. Both RAST and scratch tests were not indicative of clinical allergy in the skin and gastrointestinal tract. It was concluded that the modified scratch test may give useful information and remain as one of the routine investigative procedures in pediatric allergy.

Adolescent↗

Clinical comparison of skin testing and the radioallergosorbent test in dog-sensitive patients using mixed and breed-specific antigens.

A study of clinical history, intradermal test end points and RAST values with six different dog antigens was made in 20 patients and 5 control subjects. Skin testing was found to be more useful clinically than the RAST. Considerable variability among mixed epidermal extracts was noted. There was no apparent advantage to testing with three individual-breed extracts studied, compared to the most potent mixed epidermal antigen. The results of this study suggest that further efforts toward standardization of potency, methods of preparation and, possibly, breed composition of dog allergenic extracts are required to develop improved allergens for clinical use.

Animals↗

Allergy to pollen from different deciduous trees in Sweden. An investigation with skin tests, provocation tests and the radioallergosorbent test (RAST) in springtime hay fever patients.

92 adult patients with springtime allergy were investigated with skin tests, provocation tests and the RAST. Allergen extracts from 12 different deciduous trees were used. Positive reactions, often of high intensity, were most often found with birch, alder, bog-myrtle, beech and hazel allergens whereas oak, aspen, linden, elm, sallow, maple and poplar allergens more often gave negative or only weak positive test results. Cross sensitizations were found between botanically related as well as between less related species of the trees. Almost all patients with a clinically relevant tree pollen allergy had positive provocation tests with birch pollen. No patient had positive reactions to all the 12 allergens included in the study. 68% had positive provocation tests with the combination birch, alder and hazel. It is concluded that for diagnostic screening purposes it is sufficient to use birch pollen allergen. If the majority of relevant tree pollens are to be included in a diagnostic or therapeutic programme in Western Sweden it should contain birch, alder, hazel, beech and bog-myrtle allergens.

Adolescent↗

[Evaluation of the potency of the allergen preparation Ambrosia elatior using a skin test and the inhibition radioallergosorbent test].

The total allergenicity of a pollen extract Ambrosia elatior was measured by quantitative prick test applied to the skin of seven highly sensitive patients and by standardized method of RAST-inhibition. Five 10-fold dilutions of the allergen concentration together with histamine hydrochloride 1 mg/ml (H1) were used. The induced wheal diametres for each concentration in per cent of the patient's own histamine wheal, were calculated. There was highly significant correlation (r = 0.9951) between the intensity of IgE mediated skin reactions and the IgE binding molecules in whole pollen extract. The concentration which provides the wheal equivalent to those of H1, found by linear regression analyses, was 54.9 micrograms/ml) in order to inhibit radioallergosorbent test with a pooled serum from the same patients, containing specific IgE antibodies against relevant allergens. Relevant allergen was a disk-allergen W1 (Pharmacia Diagnostics, Uppsala) The quantity of inhibition was proportional with allergen concentration (r = 0.9813). The concentration of 55.9 micrograms/ml, by linear regression analyses elicits inhibition of 50 per cent in RAST. It is concluded that quantitative prick test and histamine estimated skin sensitivity have a good clinical applicability in assessment of releaseability of skin mast cells, and together with RAST inhibition, provides the precise combined method for calibration of an allergenic extract potency.

Adolescent↗

[Allergic rhinitis--does the radioallergosorbent test improve the diagnosis? (author's transl)].

A comparison between the skin test and radioallergosorbent test RAST) in 127 patients with allergic rhinitis reveals no advantage of RAST. This contrasts with the results obtained in other allergic diseases. However, the determination of a single pollen allergen allows the in vitro diagnosis of allergic rhinitis, which, obviously, is due to cross reactivity of pollen allergens. This makes the RAST a useful procedure in routine diagnosis, especially in the case of patients living far away from an allergy centre. In these cases RAST can easily be used as a screening test.

Allergens↗

Radioallergosorbent testing of toluene diisocyanate-reactive individuals using p-tolyl isocyanate antigen.

Serum from 26 persons shown to react to provocative inhalation challenge with low concentration of toluene diisocyanate (TDI) was tested by radioallergosorbent test (RAST) using a p-tolyl isocyanate-human serum albumin (TMI-HSA) conjugate. Results were evaluated by the RAST ratio and by the mean +3 standard deviation methods. Positive results were obtained in 15% to 19% of TDI reactors, depending on the method of evaluation. These findings suggest that TDI asthma may be a complex syndrome with several types of reaction possible, including an IgE mechanism in some individuals, but they do not support the theory that TDI asthma is based solely on an immune mechanism. However, they do not disagree with the hypothesis that TDI reactivity may be mediated by a pharmacologic mechanism.

Antigens↗

How helpful is the radioallergosorbent test in the diagnosis of allergic disease?

We compared the results of clinical history, skin testing, and radioallergosorbent test (RAST) scores on 274 patients seen in an allergy clinic, using nine different allergens, namely ragweed, oak, Bermuda grass, redtop, Timothy, Alternaria, cat hair, house dust, and dust mite. More than 90% of patients who reported clinical allergy to pollens had a positive skin test to the respective allergen. Only two thirds of these patients also had a positive RAST, while only one patient in this group had a positive RAST and a negative skin test. Of the patients reporting allergy to cat hair, 60% had a positive RAST but only 46% had a positive skin test. For the case of dust allergy, there was poor agreement between test results and history, since more than half of the patients who reported symptoms from dust exposure had a negative RAST and negative skin test results.

False Negative Reactions↗

[Allergenic relationships between Aspergillus restrictus and Aspergillus fumigatus determined by radioallergosorbent test inhibition].

Recently Aspergillus restrictus, a species of osmophilic fungi, has been found to be widely distributed in our inhabited environment. The authors reported previously that the prevalence of hypersensitivity to this fungal species determined by skin prick test and radioallergosorbent test (RAST) was comparable with that to Aspergillus fumigatus. In this study, the allergenic relationships between the two fungi were examined by RAST and RAST inhibition tests in which A. restrictus extracts prepared from mycelial mats of two different strains cultured in M40Y liquid medium and A. fumigatus, one made from a mycelial mat cultured in YNB liquid medium containing 3% sucrose, were used. In the RAST inhibition tests using a serum pool obtained from five patients with highly positive RAST to these species, the two extracts of A. restrictus inhibited RAST to A. fumigatus by over 80%, and A. fumigatus extract inhibited RAST to the two strains of A. restrictus by approximately 75%. In A. fumigatus RAST inhibition tests using individual sera with positive A. fumigatus RAST, a strong inhibition (greater than 60%) elicited by each extract of A. restrictus was observed in 5 of 8 sera tested. In RAST, nine of 11 serum samples with positive RAST to A. fumigatus showed positive RAST to both strains of A. restrictus. There was a significant correlation between the RAST values of the two fungal species. These results give evidence of the presence of shared allergenic components between the two fungi, and indicate that these components may contain part of major allergens of A. fumigatus.

Adolescent↗

Predictability of the radioallergosorbent test (RAST) in ragweed pollenosis.

The radioallergosorbent test was compared with currently accepted allergy diagnostic techniques in ragweed-sensitive and unselected patients. The radioallergosorbent test was positive in 28 of 30 patients with proved histories, positive scratch tests, and positive nasal provation tests to ragweed. The radioallergosorbent test was also positive in 69 per cent of 40 clinically sensitive patients whose diagnoses were corroborated by scratch tests alone. In unselected patients evaluated by intracutaneous testing with short ragweed extract, 10 minus 3 g per ml, the incidence of positive radioallergosorbent test scores was reduced to 43 per cent. No false positive results were encountered in these studies. A good relationship was observed between radioallergosorbent test scores and the maximal tolerable dose of ragweed administered during a course of "rush" immunotherapy in clinically allergic patients. These results suggest that the radioallergosorbent test has several unique advantages in assessing clinical sensitivity to ragweed.

Allergens↗