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PubMed1996

Association of otitis media with effusion and allergy as demonstrated by intradermal skin testing and eosinophil cationic protein levels in both middle ear effusions and mucosal biopsies.

This study was performed to ascertain the role of allergy, as defined by skin testing and histochemical markers, in the pathogenesis of otitis media with effusion (OME). A historical perspective of allergy as it relates to OME is presented. The study included 89 patients: 48 with persistent effusion but no recent acute infection, 25 with purulent OME complicated by a superimposed infection, and 16 control subjects. All 89 patients had persistent effusion for more than 2 months and subsequently required the placement of tympanostomy tubes. Allergy was defined using the radioallergosorbent test (RAST), serum immunoglobulin E (IgE) levels, and skin tests. Allergies were present in 97% of the patients with nonacute OME. The relationship between allergy and OME was corroborated clinically in 89% of patients and was also substantiated by elevated levels of effusion eosinophil cationic protein (ECP) in 87.5% of OME patients. Histologically, polyclonal antibody staining for ECP demonstrated the presence of eosinophils in middle ear mucosal biopsy specimens. This study confirms that OME is a sign of allergic inflammation in the middle ear that is associated with an increase in eosinophils and a concomitant release of ECP into the effusion in individuals with allergy demonstrated by skin testing.

Adolescent↗
PubMed2003

Intradermal skin testing in the investigation of suspected anaphylactic reactions during anaesthesia--a retrospective survey.

An anaphylactic reaction is a rare, but severe anaesthetic complication. In this retrospective survey we report on patients with a severe suspected anaphylactic reaction during anaesthesia and the investigation with intradermal skin testing of these suspected anaphylactic reactions. In the patients with an anaphylactic reaction to neuromuscular blocking drugs, the subsequent anaesthetic history was examined. Sixty-five patients suffered a suspected anaphylactic reaction between 1976 and 2001. In 47 patients skin testing was performed and 43 of these patients had positive skin tests: neuromuscular blockings drugs and succinylcholine more specifically, were the most frequently incriminated drugs. After the anaphylactic reaction 19 patients had surgery on 26 occasions with the use of a skin-test-negative neuromuscular blocking drug; no problems occurred. Skin testing proved to be a reliable tool to investigate suspected anaphylactic reactions during anaesthesia and to guide the future use of neuromuscular blocking drugs.

Adolescent↗
PubMedDate not supplied

Candidin: comparison of two antigens for cutaneous delayed hypersensitivity testing.

A candidin, which is a suspension of killed yeast cells, is commonly used for intradermal tests of delayed hypersensitivity, to evaluate the immunological cellular competence of the patient, when the test is applied along with other similar tests. When working with a cellular antigen, the histopathology of positive skin tests reveals a cellular infiltrate which not only presents a characteristic hypersensitivity reaction but also a neutrophilic abscess in the central part. This research presents the results of a comparison between the yeast cell suspension and the polysaccharide antigens, both obtained from the same strains of Candida albicans. The results obtained by skin tests in one hundred individuals were 61.0% with the polysaccharide antigen and 69.0% with the yeast cell suspension antigen. Concordant results concerning the two antigens were observed in 82.0% of the individuals. The discussion section presents an assumption to explain the differences of positivity obtained with the two antigens. We conclude that the polysaccharide antigen can be utilized in the intradermal test of delayed hypersensitivity to Candida albicans.

Anti-Bacterial Agents↗
PubMed1959

Food hypersensitivity; correlation of intradermal skin tests with clinical allergenicity.

A study was made to determine how well the results of skin tests for sensitivity to various foods agreed with observation of clinical reactions to those foods. Test reactions were divided into several categories-negative, and 1, 2, 3 or 4 plus. Then the strong reactions, that is the 3 and 4 plus reactions, the milder reactions and the negative results were studied separately to determine the agreement of results, in each category, with the clinical response. Wide variations were noted. For some foods the agreement was high, for others low. For some foods, the agreement was high in some categories of reaction, low in others. For example, negative results of skin test might match with nonreaction to the food clinically in a high proportion of cases, and 3 or 4 plus reaction to skin test might be in close agreement with the incidence of distress upon ingestion of the food, yet for the same food there might be very poor correlation between mild reaction to skin test and clinical response. This being the case, accuracy of skin tests cannot be determined simply by combining all data on reactions, of whatever degree, and taking the aggregate of agreement in all categories as an index of the validity of the test. Each category of reaction must be considered separately.Combined data and categorized data on accuracy of skin tests for sensitivity to 26 foods were tabulated in the present study.

Allergens↗
PubMed1987

Prick tests in the diagnosis of anaphylaxis to general anaesthetics.

Pre-charged prick tests and intradermal skin tests (two dilutions) were tested simultaneously in 79 patients using seven drugs (suxamethonium, gallamine, alcuronium, pancuronium, vecuronium, fentanyl and thiopentone) commonly administered during general anaesthesia. Fifty-seven of the patients had suffered anaphylaxis to anaesthetics: 50 had been tested previously (19.5 +/- 13.5 months) by intradermal tests (group 1) and seven were tested for the first time (group 2). Six patients had suffered a side effect during anaesthesia which was unrelated to anaesthetic agents (group 3) and 16 were control subjects (group 4). Prick and intradermal skin tests were simultaneously positive in 98 instances out of 553 (17.7%) and negative in 440 out of 553 (79.6%)--a correlation of 538 out of 553 (97.3%; P less than 0.001). In groups 1, 2 and 3 the correlation was 426 out of 441 (96.6%; P less than 0.001). In group 1, a correlation was observed between the diameters of the weals (r = 0.5; P less than 0.001) obtained by prick and intradermal skin tests, and between the diameters of the flares (r = 0.5; P less than 0.001).

Adult↗
PubMed1982

Classification of Mycobacterium simiae by means of comparative reciprocal intradermal sensitin testing on guinea-pigs and deoxyribonucleic acid hybridization.

This study is a contribution to the elucidation of the taxonomic relationships among Mycobacterium simiae serovars 1 and 2, other photochromogenic, mycobacterial species and the non-photochromogenic species M. avium and M. intracellulare. DNA-DNA homology percentages and comparative reciprocal intradermal sensitin reactions in guinea-pigs have confirmed that M. habana is a subjective synonym of M. simiae serovar 1 and that M. asiaticum is a separate species. The two strains of M. simiae serovar 2 studied were distinct from each other and both were distinct from M. simiae serovar 1. M. simiae was so different from M. avium and even from M. intracellulare serovars 12, 14, 16 and 19, that there is no basis for including M. simiae in the so-called M. avium-intracellulare complex. Neither did M. simiae bear any close relation to the photochromogenic species M. kansasii and M. marinum. A fairly close negative correlation was observed between the DNA-DNA homology percentages and the specificity differences of the sensitins from the same pairs of strains. This is per se a proof of the veracity of the two taxonomic methods used in the study.

Animals↗
PubMed1984

Human hypersensitivity to a sham vaccine prepared from mosquito-cell culture fluids.

A sham vaccine, prepared with the C6/36 cell line derived from larval Aedes albopictus mosquitoes, was skin tested on 12 volunteers. Although no reactions were observed after prick tests, three immediate reactions did occur after intradermal tests. Subcutaneous administration of the C6/36 sham vaccine was initially performed on the nine subjects who did not demonstrate immediate reactions. Five of these subjects developed delayed reactions at the site of the intradermal test within 12 hr after inoculation. A Prausnitz-Küstner test was performed on the back of one unsensitized subject by use of both unheated and heated sera from three subjects who had immediate skin reactions, three who demonstrated a delayed reaction, and one who had a negative skin response. In the Prausnitz-Küstner test, immediate skin reactions were observed with all seven unheated sera but with none of the heated serum aliquots. The determination that skin reactivity was associated with a heat-labile serum factor suggested the mechanism was IgE-mediated. Under close surveillance, the C6/36 sham vaccine was administered subcutaneously to one volunteer who had previously demonstrated an immediate response. This subject developed an anaphylactic reaction characterized by hives at the site and more distantly from the site of the subcutaneous inoculation. Hypersensitivity to A. albopictus larval antigens is common and precludes the use of C6/36 cell culture as a substrate for viral vaccines.

Cells, Cultured↗
PubMed1988

Anaphylactoid reaction to vecuronium followed by systemic reaction to skin testing.

An unusual case is presented of a systemic anaphylactoid reaction to tubocurarine and subsequently to vecuronium. Intradermal testing with vecuronium following the latter response was negative at recommended test dose levels but at a higher concentration it initiated a hazardous systemic response. The laboratory investigations and possible mechanisms involved in this unusual case are discussed in detail since they may relate to other patients who experience anaphylactoid responses to anaesthetic drugs and who then undergo intradermal testing.

Adult↗
PubMed1996

Natural rubber latex skin testing reagents: safety and diagnostic accuracy of nonammoniated latex, ammoniated latex, and latex rubber glove extracts.

BACKGROUND: Nonammoniated latex, ammoniated latex, and rubber glove extracts are the only sources of natural rubber (Hevea brasiliensis) latex that have potential for use as skin testing reagents in the diagnosis of latex allergy. Their diagnostic sensitivity and specificity as skin test reagents are unknown. OBJECTIVE: We conducted a phase 1/2 clinical study to examine the safety and diagnostic accuracy (sensitivity and specificity) of nonammoniated latex, ammoniated latex, and rubber glove extracts as skin test extracts to identify the most efficacious source material for future skin test reagent development. METHODS: Twenty-four adults not allergic to latex, 19 adults with hand dermatitis or pruritus, and 59 adults with a latex allergy were identified by clinical history. All provided blood and then received puncture skin tests and intradermal skin tests with nonammoniated latex, ammoniated latex, and rubber glove extracts from Malaysian H. brasiliensis latex by use of sequential titration. A glove provocation test and IgE anti-latex RAST were used to clarify positive history-negative skin test response and negative history-positive skin test response mismatches. RESULTS: All three extracts were biologically safe and sterile. After normalization to 1 mg/ml of total protein, all three extracts produced equivalent diagnostic sensitivity and specificity in puncture skin tests and intradermal skin tests at various extract concentrations. Optimal diagnostic accuracy was safely achieved at 100 micrograms/ml for intradermal skin tests (e.g., nonammoniated latex: puncture skin test sensitivity 96%, specificity 100%; intradermal skin test sensitivity 93%, specificity 96%). The presence of IgE antibody in skin was highly correlated with IgE anti-latex in serum (nonammoniated latex: r = 0.98, p < 0.001; ammoniated latex: r = 0.94, p < 0.001; rubber glove extract: r = 0.96, p < 0.001). All five available subjects with a positive history, negative skin test response, and absence of IgE antibody in serum had a negative glove provocation test response, indicating no clinical evidence of latex allergy. No systemic or large local allergic reactions were observed with puncture skin tests or intradermal skin tests. CONCLUSIONS: Equivalent diagnostic sensitivity and specificity were observed with the nonammoniated latex, ammoniated latex, and rubber glove extract skin test reagents after normalization for total protein; nonammoniated latex may be considered the reagent of choice on the basis of practical quality control and reproducibility considerations.

Adult↗
PubMed1986

Comparative evaluation of enzyme-linked immunosorbent assay for the diagnosis of pulmonary echinococcosis.

An enzyme-linked immunosorbent assay was done for the detection of immunoglobulin G and M (IgG and IgM) antibodies to Echinococcus granulosus in surgically proved cases of hydatidosis, especially pulmonary hydatidosis, by use of human hydatid cyst fluid antigen and soluble scolex antigen. This assay was compared with the following standardized techniques: the indirect hemagglutination test, the indirect immunofluorescent antibody test, and Casoni's intradermal test. The enzyme-linked immunosorbent assay, with either of the antigens (human hydatid cyst fluid or soluble scolex antigen), was more sensitive and specific than the other techniques in diagnosing cases of hydatidosis, especially hydatid disease of the lung.

Antigens, Helminth↗