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PubMed1990

[Immunological screening of clonorchiasis].

Crude antigens of Clonorchis sinensis adult worms were purified by Sephadex G-200 column chromatography. A purified antigen was then applied to detect clonorchiasis patients and parasite-free subjects by an enzyme-linked immunosorbent assay (ELISA) and an intradermal test (IDT). The results of the ELISA showed that specific antibody levels of IgG, IgM, IgA, IgE and total IgE in 371 infected patients were significantly higher than those of 181 parasite-free subjects (Student's t-test, p less than 10(-6) or p less than 0.005). The sensitivity was 92.8% and the specificity was 89.0%. Significant correlations between the intensity of infection, expressed as egg per gram feces, and specific IgG, IgA and total IgE concentration were observed (linear regression, p less than 0.0005). Among the 309 subjects tested intradermally with Clonorchis antigen, 128 showed a positive reaction while all of the 60 parasite-free subjects showed negative results. By this test, the sensitivity was 49% and the specificity of IDT was 100%. The specific IgG, IgA and total IgE antibody levels of the IDT positive patients were significantly higher than those of the negative subjects (Student's t-test, p less than 0.0005). There was no correlation between the induced swelling diameter and the intensity of infection in IDT positive clonorchiasis patients. Cross reactions in ELISA were observed in patients infected with Capillaria philippinensis, Sparganum proliferum and Toxocara canis, when the antigens prepared in the present study were used.

Animals↗
PubMed2002

Allergic contact dermatitis from mercury antiseptics and derivatives: study protocol of tolerance to intramuscular injections of thimerosal.

BACKGROUND: Mercury derivatives are frequent contact allergens and their cross-reactivity is not constant. Thimerosal is an organic mercurial used as an antiseptic and as a preservative in most vaccines. OBJECTIVE: To evaluate cross-reactivity, exposure factors, and tolerance to vaccines containing thimerosal in patients sensitized to mercury derivatives. METHODS DESIGN: Observational study (cross-sectional); PATIENTS: 125 patients were recruited for the study, 72 women and girls and 53 boys and men, average age 18.7 years old, range 3 to 65, with positive patch tests to mercury derivatives and/or thimerosal; INTERVENTIONS: All patients were studied by means of enquiry, patch tests, intradermal tests, and intramuscular challenge with thimerosal. RESULTS: A sensitization to thimerosal was observed in 57 patients. Twenty-four of these 125 patients presented a positive intradermal reaction. Ammoniated mercury seems to be a good marker of mercury sensitization eliciting positive reaction in 78% of all patients and merbromin in 66%. In most cases, (100/125) cross-reactivity was found among mercury derivatives. The intramuscular injection of thimerosal induced a mild local reaction in only 5 patients (4% of the total, 9% of thimerosal positive reactions). Childhood vaccinations, merbromin used as an antiseptic, broken thermometers, and the use of drops were the main sources of exposure. CONCLUSIONS: The majority of the patients showed positive tests to both organic and inorganic mercury derivatives. Vaccination with thimerosal is relatively safe, even for individuals with delayed type hypersensitivity to this chemical, since more than 90% of allergic patients tolerated intramuscular challenge tests with thimerosal. A simplified protocol of patch tests to study mercury derivatives is proposed. It would be advisable to restrict the use of mercurial antiseptics and mercury thermometers.

Adolescent↗
PubMed1982

A review of kala-azar in China from 1949 to 1959.

This is the first account of China as an important area of kala-azar to appear in the west for nearly 50 years. The review is divided into four main sections. The epidemiological aspects which are described include the geographical distribution and endemicity (under the sub-headings natural conditions of the epidemic area, age distribution, sex differences, seasonal changes in incidence) and research on reservoirs (under the sub-headings survey of canine leishmaniasis and survey of other wild and domestic animals). The section on clinical aspects covers symptoms and signs, post kala-azar dermal leishmaniasis, laboratory diagnosis (puncture, serum tests, complement fixation test, intradermal test) and treatment (medication and the effects of treatment). The possibility that two different types of kala-azar occur in China is discussed and the paper concludes with an appraisal of the present position.

Adolescent↗
PubMed2001

Chronic urticaria associated with intra-articular methylprednisolone.

Reports of allergic reactions following treatment with systemic corticosteroids are rare, despite their widespread use. A 47-year-old man developed widespread urticaria, resistant to antihistamines, coinciding with injections of local anaesthetic and methylprednisolone for cervical spondylosis. He underwent immediate and delayed hypersensitivity tests. Intradermal tests showed immediate-type sensitivity to methylprednisolone and hydrocortisone. Patch tests were positive to 21 of 26 corticosteroids tested. A diagnosis of both an immediate and a delayed-type hypersensitivity to corticosteroids was made. With avoidance of all corticosteroids he has been free from urticarial rash for 9 months and has been able to stop all medication.

Administration, Topical↗
PubMed2003

Long-term repeatability of the skin prick test is high when supported by history or allergen-sensitivity tests: a prospective clinical study.

BACKGROUND: Long-term reproducibility of the skin-prick test (SPT) has been questioned. The aim of the study was to investigate the clinical relevance of SPT changes. METHODS: SPT to 10 common inhalation allergens was performed annually from 1999 to 2001 in 25 nonsensitized and 21 sensitized subjects. An SPT was positive when > or =3 mm, and repeatable if either persistently positive or negative. Clinical sensitivity to birch pollen was used as model for inhalation allergy, and was investigated at inclusion and at study termination by challenge tests, intradermal test, titrated SPT and IgE measurements. Birch pollen symptoms were confirmed in diaries. RESULTS: The repeatability of a positive SPT was 67%, increasing significantly to 100% when supported by the history. When not supported by history, the presence of specific IgE was significantly associated with a repeatable SPT. Allergen sensitivity was significantly lower in subjects loosing SPT positivity. The repeatability of a negative test was 95%, decreasing significantly to 87% by the presence of other sensitization. Development of a positive SPT was clinically relevant. Elevation of SPT cut-off point did not enhance repeatability. CONCLUSION: SPT changes are clinically relevant. Further studies using other allergens are needed. Long-term repeatability of SPT is high in the presence of a supportive history.

Adult↗
PubMed1990

Corticosteroid sensitivity and cross-sensitivity. A review of 18 cases 1967-1988.

506 patients were suspected of being allergic to corticosteroid medicaments in our clinic during the 22 years from 1967 to 1988. Patch tests were performed in these patients. Scratch tests, intradermal tests, and challenge tests were also carried out in some cases. 69 patients showed positive reactions to corticosteroid products (as is). 18 were allergic to the corticosteroid itself and 44 were sensitive to vehicle components or other active ingredients. In 7 cases, the allergen could not be detected. Patients who were allergic to corticosteroids were tested for their cross-sensitivity with our corticosteroid patch test series. Cross-reactions tended to occur between members of the same corticosteroid type, and some of the combinations of different corticosteroid types cross-reacted with each other. Corticosteroid-sensitive cases have increased in number during these 22 years. Corticosteroid sensitivity is not as rare as formerly thought.

Adult↗
PubMed2006

The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population.

Suspected penicillin allergy is common among hospitalised patients, but the quality of the information given by the patient is often doubtful. Alleged penicillin allergic are likely to be treated with more toxic, broad-spectrum, and more expensive antibiotics, with effects on microbial resistance patterns and public economy as a consequence. We performed a cross-sectional case-control study with two visits to all clinical departments of a large university hospital in order to find in-patients with medical files labelled "penicillin allergy" or who reported penicillin allergy upon admission. Patient histories were obtained via a questionnaire, and they were offered investigation for penicillin allergy with specific IgE, basophil histamine release, skin prick tests, intradermal tests and drug challenge tests. Finally, the pharmaco-economical consequences of the penicillin allergy were estimated. In a cohort of 3642 patients, 96 fulfilled the inclusion criteria giving a point-prevalence of alleged penicillin allergy of 5% in a hospital in-patient population. Mean time elapsed since the alleged first reaction to penicillin was 20 years. The skin was the most frequently affected organ (82.2%), maculo-papular exanthema (35.4%) and urticaria (10.4%) being the most frequently reported reactions. 25% did not recall the time of their reaction. 82.2% did not remember the name of the penicillin they reacted to. 34.8% had been treated with penicillins after suspicion of penicillin allergy had been raised. None of these reacted to penicillins. 33.3% of the patients receiving antibiotics during their current hospitalisation were prescribed penicillins. 2% developed non-severe exanthema. The average acquisition costs for antibiotics to penicillin allergic patients were euro 278, compared to euro 119 had they been non-allergic. The prevalence of suspected penicillin allergy was lower than reported elsewhere. A substantial number of patients failed to recall basic information about their alleged allergy. Patients reporting penicillin allergy upon admission and labels stating penicillin allergy on medical files are ignored in almost a third of patients receiving antibiotics. The acquisition costs for antibiotics to penicillin allergic patients were higher, compared to the cost had the patients been non-allergic.

Adolescent↗
PubMed1990

Paratuberculosis in a cattle herd: comparison of allergic, serologic and faecal microscopic tests.

In a beef herd of 230 cows kept on pasture and infected with Mycobacterium paratuberculosis, faecal samples were tested microscopically and the blood serum by the complement fixation and the immunodiffusion test. Intradermal tests were carried out simultaneously with bovine and avian tuberculin as well as with two dilutions (0.86 mg/ml and 0.50 mg/ml tuberculoprotein) of paratuberculin. In the tested herd 35.2% of the cows gave positive faecal tests while 10 and 9.1% were positive in the agar gel immunodiffusion (AGID) and complement fixation test (CFT), respectively. The allergens showed wide variations, but as a whole they were positive in 58.1% of the faecal positive, and in 60.9 and 76.2% of the AGID and CFT positive ones, respectively. The allergic tests were positive in 54.4, 53.7 and 52.2% of the faecal, AGID and CFT negative cows, respectively. The prognosis of such herds is disadvantageous. Elimination of infection can only be expected if after improvement of hygienic circumstances the diseased animals are continuously culled and a new breeding stock reared in isolation.

Animals↗
PubMed1997

[Echinococcus of the kidney].

Echinococcus of the kidney is a rare form of hydatid disease, and accounts for 2 to 3 per cent of all echinococcoses. Over a ten-year period (1987-1996), eight patients with age ranging from 30 to 61 years are diagnosed and treated. Five of them (62.5 per cent) are discovered in the last two years. In seven instances (87.5 per cent) the diagnosis is made preoperatively on the ground of laboratory examinations; serological tests--intradermal test of Casoni and complement fixation after Ghedini-Weinberg, echographic and roentgenological methods. In two patients (33.3 per cent) scoleces and Echinococcus fragments are discovered in the urine. The serological tests are positive in five cases (62.5 per cent). All patients undergo operation, with nephrectomy performed in five (62.5 per cent), and capsula adiposa renis--in three (37.5 per cent). So far, no relapse of the disease is recorded.

Adult↗
PubMed2003

Alternative glucocorticoids for use in cases of adverse reaction to systemic glucocorticoids: a study on 10 patients.

BACKGROUND: Reactions to systemically administered corticosteroids are rare, despite their widespread use. OBJECTIVES: To identify alternative glucocorticoids for emergency use in patients with adverse reactions to systemic glucocorticoids. METHODS: Ten patients were identified as having adverse reactions after the use of systemic corticosteroids. Skin prick tests and intradermal tests to hydrocortisone (HC) and methylprednisolone (MP), and intradermal tests to betamethasone and dexamethasone, were performed in all patients, and oral challenge tests to betamethasone (n=10) and deflazacort (n=6). RESULTS: Skin prick tests were negative in all patients, whereas intradermal tests to HC and MP were positive in eight; two patients showed only an isolated cutaneous sensitivity to MP. Intradermal tests to betamethasone and dexamethasone were negative, and oral challenge tests were negative in all patients. CONCLUSIONS: Our results suggest the possibility of an IgE-mediated mechanism for allergic reactions to HC and MP, probably due, at least in part, to a steroid-glyoxal. We suggest that betamethasone and deflazacort could be reserved for emergency use in patients with adverse reactions to other corticosteroids.

Adult↗
PubMed1961

Evaluation of some laboratory procedures in diagnosing infections with Schistosoma mansoni.

THIS PAPER REPORTS ON A COMPARATIVE EVALUATION CARRIED OUT IN PUERTO RICO ON THE FOLLOWING PROCEDURES USED IN DIAGNOSING BILHARZIASIS: recovery of S. mansoni ova from stools; serological tests (complement-fixation tests with adult worm and cercarial antigens, slide flocculation test with cercarial antigens, cercarial agglutination test, and circumoval precipitin test) and intradermal tests with adult worm, cercarial and egg antigens.Stool examinations revealed infections in only 74% of 485 patients hospitalized for bilharziasis, but most of the serological and intradermal tests gave results which, when corrected for false negative reactions, suggested infections in 89%-94% of patients. Cercarial agglutination results were discounted because of weak reactions and low specificity; the intradermal test with egg antigen lacked specificity.From the results of their comparative studies, the authors suggest particular uses for the various serological and stool tests, but consider that the intradermal tests do not appear to have a definable role in the diagnosis or detection of bilharziasis.

Adult↗
PubMed1997

Unusual manifestations of hypersensitivity after a tick bite: report of two cases.

BACKGROUND: Ticks are able to transmit, through biting, various viral, parasitic, and bacterial diseases, the best known being Lyme disease due to Borrelia burgdorferi. In addition, ticks may also induce allergic reactions. OBJECTIVE: A study of immediate and delayed skin reactions are undertaken to give evidence of an IgE-dependent mechanism. METHODS: Two lumbermen reported having had skin reactions following bites by ticks. Skin prick tests and intradermal tests were performed with what was most probably Ixodes ricinus extract in one case. Specific IgE to whole body extract of wood tick were assayed by radioimmunoassay. Histological and immunohistologic examinations of skin biopsy obtained from a pruriginous skin lesion and from a delayed reaction following the intradermal test, were performed. RESULTS: One of them had positive immediate reactions to a prick test and an intradermal test with the same extract. Both patients had significant levels of wood tick-specific IgE antibody as well as elevated serum total IgE levels. Histologic examinations of a pruriginous lesion revealed lymphocytic dermal and perivascular infiltration, with evidence of CD8+ T lymphocytes and Langerhans' cells in the perivascular infiltrates. A biopsy of the place of the delayed reaction following the intradermal skin test also showed the presence of dermal and perivascular lymphocytic infiltrates. CONCLUSION: IgE-dependent allergy to Ixodes ricinus can explain allergic reactions. Standardized extracts have to be prepared with sufficient amounts of the relevant tick salivary antigens to permit diagnosis by skin and serologic tests of patients, especially lumbermen who may be allergic to Ixodes ricinus.

Adult↗
PubMed1986

[Fractionation of antigen for ELISA of bovine fascioliasis]

In order to obtain the most specific and sensitive antigen from crude antigens of Fasciola hepatica for the immunodiagnosis of bovine fascioliasis by the enzyme linked immunosorbent assay(ELISA), phosphate buffered saline extract of F. hepatica was prepared. The crude extract was fractionated into 7 antigens using Sephadex G-100 column chromatography. Seven fractionated antigens were applied to ELISA, precipitation test and intradermal test, respectively. Results obtained are as follows: The specificity (95 per cent confidence interval in negative sera of bovine fascioliasis; Mean+2 x SD of absorbance ) of the first (MW>150,000) and the second antigens (MW 120,000) were 93.7 per cent, but those of others including crude antigen showed 100 per cen.t. The sensitivity (positive sera of bovine fascioliasis having higher values with compared to the criterion) of the first, the sixth (MW 16,000) and the seventh antigen (MW<5,000) were 91.6 per cent, 87.5 per cent and 0 per cent, respectively, but those of others showed all 100 per cent. The absorbance by ELISA using the fifth antigen (MW 26,000) was 8.43-folds higher in the positive sera than that in the negative sera. This could be used as one of the most specific antigens for the immunodiagnosis of bovine fascioliasis. In Ouchterlony test, precipitin lines were not found in the sera naturally infected with F. hepatica, but some were found in the sera of rabbits immunized with the crude antigens. The numbers of precipitin lines in the sera of rabbits were different in the different fractionated antigens. They were 6 in the crude, 2 in the second and the third antigens, 1 in the forth, the fifth and the sixth antigens and absent in the seventh antigen, respectively. The wheal size for the bovine infected with F. hepatica was 2.46+/-0.15 cm in the intradermal test antigen (saline extract of F. hepatica) supplied by the Veterinary Research Institute, Rural Development Administration, Korea. The wheal size of the first, the second and the third antigens were larger than that of intradermal test antigen, whereas those of the forth, the fifth, the sixth and the seventh antigens showed smaller than that of the intradermal test antigen. The results suggest that the fifth antigen may be specific antigen for the immunodiagnosis of bovine fascioliasis.

Journal Article↗
PubMed1991

Anaphylaxis to muscle-relaxant drugs: study of cross-reactivity by skin tests.

Intradermal skin tests (two dilutions) carried out systematically with 5 muscle-relaxant drugs were used to study the cross-reactivity between these drugs in 131 patients who had suffered from anaphylaxis. The skin tests were positive for at least 2 drugs in 65.6% of the cases. We observed a significant concordance (positive-positive or negative-negative skin tests) between pancuronium and vecuronium (p less than 0.01) and a significant correlation between the skin test diameters obtained with these 2 drugs (p less than 0.02 for wheals and p less than 0.01 for flares). Conversely, the lack of concordance between pancuronium and suxamethonium was significant (p less than 0.05). When comparing all the concordances obtained with each pair of drugs, it appeared that the concordance between pancuronium and vecuronium was significantly higher than all others. For other concordances, 2 main factors seemed to play a role: the N+ of the ammonium ions included in a ring as in pancuronium and the presence of a 'choline-like' side chain as in suxamethonium. But there was no significant correlation between skin test diameters. Altogether, these results suggest that in vivo there is no 'true' cross-reactivity between the drugs except frequently between pancuronium and vecuronium. In all other cases, the patients have probably specific IgE antibodies for each drug, all these antibodies being able to recognize the ammonium determinant; this common property may be insufficient to induce a clinical allergy.

Adolescent↗
PubMedDate not supplied

[A comparison of two antigens for Montenegro skin test].

Intradermal reactions were performed in 399 individuals by using, simultaneously, the antigen produced by both the Universidade Federal de Minas Gerais and Fundação Instituto Oswaldo Cruz. Each of these antigens was manufactured with promastigotes of Leishmania (L) amazonensis (IFLA/BR/67/PH8). The Fundação Oswaldo Cruz antigen caused a larger number of positive reactions. Discordant reactions occurred in 22% of the individuals.

Animals↗
PubMed1984

Comparison of tests for the diagnosis of spontaneous encephalitozoonosis in rabbits.

The effectiveness of immunofluorescence, complement fixation, microagglutination serologic tests, intradermal skin test, and detection of histologic lesions were compared for use in diagnosis of spontaneous encephalitozoonosis in rabbits. The India ink and microbead agglutination reactions were compared with immunofluorescence and complement fixation by testing 11 single or pooled sera. Serologic tests correlated best with each other and less well with intradermal tests or presence of lesions. Immunofluorescence, India ink reaction and microbead agglutination were equally useful in detecting antibodies to Encephalitozoon cuniculi. The intradermal test correlated best with the presence of detectable lesions.

Agglutination Tests↗
PubMed2005

Role of intradermal skin tests in the evaluation of clinically relevant respiratory allergy assessed using patient history and nasal challenges.

BACKGROUND: Skin testing, correlated with patient history, is the accepted method of identifying clinically relevant aeroallergen sensitivity. Traditionally, intradermal tests are believed to be more sensitive in identifying aeroallergen sensitivity than the epicutaneous and percutaneous methods. Therefore, many allergy practitioners use the epicutaneous or percutaneous method first and, if the results are negative, follow up with intradermal tests. OBJECTIVES: To compare the epicutaneous, percutaneous, and intradermal methods to determine their sensitivity to patient history and to evaluate the value of intradermal tests when epicutaneous and percutaneous test results are negative. METHODS: Participants were evaluated for rhinoconjunctivitis symptoms and then were skin tested using the prick and Multi-Test II (MTII) methods. Intradermal tests were performed when prick and MTII test results were negative to an aeroallergen. Participants with negative prick and MTII test results and corresponding positive intradermal test results underwent nasal challenges with evaluation by anterior rhinomanometry. RESULTS: Compared with patient history, average sensitivity for MTII was 77% and for the prick method was 62%. When MTII results were negative, 17% of intradermal tests corresponded with probable patient histories of allergy but none with positive nasal challenge results. Nasal challenge results were similar to those of the negative control group and significantly different from those of the positive control group (P < .001). CONCLUSIONS: The MTII tests are more sensitive and equally specific compared with the prick method. When MTII results are negative, positive intradermal test results are unlikely to identify clinically relevant aeroallergen sensitivity. Routine performance of intradermal tests when MTII results are negative is likely to be of low clinical yield.

Adolescent↗
PubMed1992

[Investigation of immunogenic properties of diphtheria antitoxin by intradermal active test of potency].

Usefulness of four variants of intradermal test for routine testing of protective potency and diphtheria anatoxin was studied. Comparing with classical active test it was found that full intradermal test possesses data system and results comparable to the classic test and may replace it. This in effect results in four-fold reduction of guinea pig number necessary for performance of the investigation. As orientating test, estimate determining AnaDi potency a single dose performed on six guinea pigs was selected. In the intradermal test the time of investigation, as compared with the classic test, may be shortened by one week.

Animals↗