scholarly journals Tolerance of porcine pancreatic enzymes despite positive skin testing in alpha-gal allergy

2020 ◽  
Vol 8 (5) ◽  
pp. 1728-1732.e1 ◽  
Author(s):  
Cosby A. Stone ◽  
Shailesh Choudhary ◽  
Megan F. Patterson ◽  
Christine R.F. Rukasin ◽  
David T. Coleman ◽  
...  
Keyword(s):  
Skin Testing ◽  
Pancreatic Enzymes ◽  
Positive Skin

Coccidioidomycosis of the Larynx in Infants and Adults

1977 ◽  
Vol 86 (5) ◽  
pp. 655-660 ◽  
Author(s):  
Paul H. Ward ◽  
David Morledge ◽  
George Berci ◽  
Harmon Schwartz
Keyword(s):  
United States ◽  
Amphotericin B ◽  
Clinical Symptoms ◽  
Skin Testing ◽  
Fungal Disease ◽  
Southwestern United States ◽  
Positive Skin ◽  
Life Threatening ◽  
Primary Form

Coccidioidomycosis is a fungal disease endemic to the southwestern United States. The primary form of the disease is relatively benign and many patients, after exposure by inhalation of the sapyrophytic form of the organism, convert from negative to positive skin testing without significant clinical symptoms. The less common disseminated form represents a serious life-threatening disease and can present with granulomatous changes in the larynx. The authors' experience with disseminated coccidioidomycosis presenting in the larynx of adults and infants successfully treated with amphotericin B are presented and discussed.

THE CUTANEOUS REACTION TO EGGWHITE

PEDIATRICS ◽  
1959 ◽  
Vol 24 (6) ◽  
pp. 1009-1015
Author(s):  
Richard L. London ◽  
Jerome Glaser
Keyword(s):  
Skin Test ◽  
Skin Testing ◽  
Intradermal Test ◽  
Skin Tests ◽  
Etiologic Factor ◽  
Initial Reaction ◽  
Age Group ◽  
Positive Skin ◽  
Clinical Sensitivity ◽  
Number Of Patients

A study of 400 allergic patients of all ages, who were skin tested with eggwhite, is reported. The authors agree with those who believe that a positive reaction in infants who have in no known way been exposed to eggwhite after birth is in all probability due to intrauterine sensitization. There is a possibility, however, that some reactions to eggwhite may be due to a primary histamine or serotonin releasing substance present in the eggwhite which has no relationship to antigen-antibody reaction. The circumstances under which this takes place are not known. In all age groups the family history was positive in about 65% of cases. It was surprising to find, in view of previous opinions, that in the youngest age group (infants up to 2 years of age), the skin test was positive in less than half the patients (42%) in the presence of clinical sensitivity. It was also unexpected to find that the number of patients clinically sensitive to eggwhite but giving negative skin tests increased as age advanced. This justifies the common practice of eliminating egg as a trial measure in the diet of the first age group, regardless of the results of skin testing, and suggests that this should be done in any age group where food is considered a possible etiologic factor. In the youngest age group somewhat more than one-third (34%) of the patients reacted positively to eggwhite but were not clinically sensitive. This finding was completely unexpected as it had been thought that in this age group a positive skin test to eggwhite was practically pathognomonic of clinical sensitivity. In this study more positive reactions in children to eggwhite were obtained (70.5%) than in a somewhat comparable series where the incidence was much less (20%). We attribute this to the fact that in our series both scratch and intradermal tests were made while in the other series only scratch tests were done. This reflects the greater sensitivity of the intradermal test. Only about half the patients of all ages who react to eggwhite are also clinically sensitive. Attention is drawn to a theory which explains why a positive cutaneous test to a food, as eggwhite, may be clinically significant in atopic dermatitis even though the test (wheal reaction) does not reproduce the type of dermatitis being studied. There was no definite evidence, because the number of cases studied is far too small, to indicate that the severity of asthma which may ultimately develop in infants not asthmatic at the time of skin testing is proportional to the strength of the initial reaction to eggwhite.

Scar Formation and Tuberculin Conversion Following BCG

2021 ◽  
Vol 15 (11) ◽  
pp. 3056-3057
Author(s):  
Muhammad Sarfraz ◽  
Zahid Jamil ◽  
Muhammad Naim Ashraf ◽  
Saima Arshad ◽  
Zirwa Sarfraz ◽  
...  
Keyword(s):  
Skin Testing ◽  
Case Series ◽  
Operational Definition ◽  
Scar Formation ◽  
Bcg Vaccine ◽  
Base Line ◽  
Positive Skin ◽  
Post Vaccination ◽  
Vaccination Programs ◽  
Bcg Vaccination

Objective: To determine frequency of scar formation and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age presenting at outpatient department of Fauji Foundation Hospital Lahore. Study Design: Descriptive case series. Place and Duration of Study: Outdoor Department of Pediatrics, Fauji Foundation Hospital, Lahore from 1st July 2020 to 30th December 2020. Methodology: Ninety seven children were included. Base line demographic information of patients (age, gender, weight on weight machine) was recorded. 0.5 ml BCG was administered in right arm. Tuberculin skin test was assessed as per operational definition. After 48 to 72 hours, scar formation was assessed after 1 month. Data regarding scar formation and positive tuberculin conversion test was recorded. Results: The mean age was 3.20±1.46 years, 39 (40.21%) were male whereas 58 (59.79%) were females. The scar formation following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age was 59 (60.82%) and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years was recorded in 47 (48.45%). Conclusion: Most babies have developed a post-vaccination scar. The combination of the BCG scar and the positive skin testing tuberculin was very important. The development of BCG scars had no effect on age or sex. Greater trials are advised in order to detect the true extent of the problem and to evaluate regularly the BCG vaccination programs. Keywords: Infants, Tuberculosis, BCG vaccination, Scar formation, Positive tuberculin conversion test

SKIN TEST REACTIVITY TO BEE HIVE PRODUCTS (HONEY BEES, HONEY, ROYAL JELLY AND POLLEN)

2016 ◽  
Vol 78 (5-10) ◽  
Author(s):  
Mai Shihah Abdullah ◽  
Nasuruddin Abdullah
Keyword(s):  
Skin Test ◽  
Honey Bee ◽  
Honey Bees ◽  
Royal Jelly ◽  
Skin Testing ◽  
Positive Skin Prick Test ◽  
Positive Skin ◽  
Skin Test Reactivity ◽  
Bee Pollen ◽  
Allergen Extracts

Bee hive products such as honey bees, honey, royal jelly and pollen are widely consumed as a health supplement. There has been several cases of allergic reactions to bee hive products reported worldwide. Consumption of bee hive products is common among Malaysians, but the degree of its sensitization is not known. The aim of this study is to determine the prevalence of skin test reactivity to Apis mellifera, domesticated locally and the bee hive products such as honey bees, honey, royal jelly and pollen among a group of volunteers. Four types of honey collected from different locations with different plant sources; one sample of imported honey from Australia, one sample of royal jelly, four different sources of bee pollen, and honey bee derivatives were used to prepare allergen extracts for skin testing. 2522 volunteers were skin tested to these allergen extracts. 271 (10.75%) of the subjects had a positive skin prick test result to at least one honey bee derivative or bee hive product allergen. Individuals with skin test positivity to honey bee are most likely to be sensitized to bee pollen followed by honey and royal jelly. Skin test reactivity to honey bee and bee hive products is prevailed to be high in Malaysia. This study has proven that bee hive products sensitization individuals are mostly to be also sensitized to honey bees. Therefore, is recommended these allergens to be included in the skin prick panel

scholarly journals Anaphylaxis to intravenous paracetamol containing povidone. A case report and narrative review of excipient allergy related to anaesthesia

2020 ◽  
Vol 48 (5) ◽  
pp. 404-408
Author(s):  
James F Preuss ◽  
Catherine E Goddard ◽  
Russell C Clarke ◽  
Peter R Platt ◽  
Paul HM Sadleir
Keyword(s):  
Skin Testing ◽  
Recovery Period ◽  
Parent Compound ◽  
Alternative Formulation ◽  
Positive Skin ◽  
Intradermal Testing ◽  
Detailed History ◽  
Intravenous Paracetamol ◽  
Potential Trigger ◽  
The Individual

Investigation of intraoperative anaphylaxis includes the exclusion of potential trigger agents the individual was exposed to within a plausible interval preceding the reaction. Occasionally, none of these agents will test positive. In this situation it is important to consider that excipients may be responsible for anaphylaxis, that the dilutions prepared to test the medication may not contain an appropriate concentration of the excipient to induce a positive skin reaction, or if an alternative formulation of the medication is tested, it may not contain the culprit excipient. This case describes a patient, who previously experienced an anaphylactic reaction to Betadine® (Sanofi-Aventis Australia Pty Ltd, North Ryde BC, NSW) experiencing anaphylaxis in the recovery period after general anaesthesia where Betadine was avoided. The recently administered therapeutics were excluded by skin testing, however further investigation determined that a povidone-containing formulation of paracetamol had been administered. Skin testing with povidone-containing paracetamol resulted in a positive reaction in the patient, but not in a volunteer control. Pharmaceutical excipients are added to medications to increase absorption, shelf-life and efficacy. Different brands of the same drug may contain different excipients. When testing for anaphylaxis with such compounds one must be sure the dilution is appropriate for both the parent compound and the excipient to ensure the accuracy of skin-prick and intradermal testing. This case demonstrates the potential for excipients to cause severe allergy and the importance of detailed history pertaining to previous allergic episodes as even the most unlikely of medications can potentially result in anaphylaxis due to excipients.

scholarly journals Tuberculin Skin Testing Boosts Interferon Gamma Responses to DIVA Reagents in Mycobacterium bovis-Infected Cattle

2017 ◽  
Vol 24 (5) ◽  
Author(s):  
Gareth J. Jones ◽  
Mick Coad ◽  
Bhagwati Khatri ◽  
Javier Bezos ◽  
Natalie A. Parlane ◽  
...  
Keyword(s):  
Skin Test ◽  
Mycobacterium Bovis ◽  
Interferon Gamma ◽  
Skin Testing ◽  
Interferon Response ◽  
Tuberculin Skin Testing ◽  
Test Scenario ◽  
Positive Skin ◽  
Content Type ◽  
Bcg Vaccination

ABSTRACT Mycobacterium bovis BCG vaccination sensitizes cattle to bovine tuberculin, which compromises the use of the current bovine tuberculosis (TB) surveillance tests. Although the performance of a blood test (that utilizes antigens expressed by Mycobacterium bovis but not by BCG) capable of discriminating infected from vaccinated animals (DIVA interferon gamma test [DIT]) has been evaluated in naturally infected TB field reactors, there is a need to perform similar analysis in a BCG-vaccinated M. bovis-infected population. Furthermore, we explored different scenarios under which a DIT may be implemented alongside BCG vaccination: (i) serial testing to resolve potential false-positive skin test results or (ii) a standalone test to replace the single intradermal comparative cervical tuberculin (SICCT) skin test. Our results demonstrated significantly better relative test sensitivity when the DIT was evaluated in a serial test scenario. Direct comparison of pre- and post-skin test blood samples revealed that the SICCT test induced significant boosting of the gamma interferon response in M. bovis-infected animals to both the ESAT-6–CFP-10 and Rv3615c peptide cocktails that comprise the DIT, which persisted for the ESAT-6–CFP-10 reagent for at least 14 days. Importantly, no similar boosting effects were observed in noninfected BCG vaccinates, suggesting that DIVA blood testing after a recent skin test would have minimal impact on test specificity.

scholarly journals Prevalence of Laryngeal and Pharyngeal Symptoms in Patients with Environmental Allergy

2014 ◽  
Vol 4 (1) ◽  
pp. 1-4
Author(s):  
Manish D Shah ◽  
Sarah K Wise ◽  
Melissa R Rotella ◽  
Avani P Ingley ◽  
Michael M Johns
Keyword(s):  
Retrospective Review ◽  
Skin Testing ◽  
Causal Link ◽  
Skin Tests ◽  
Insufficient Evidence ◽  
Positive Skin ◽  
Nasal Symptoms ◽  
Significant Difference ◽  
Inhalant Allergy ◽  
Allergy Skin Testing

ABSTRACT Background The effect of environmental allergy on laryngeal and pharyngeal complaints is not well understood. The goal of this study was to determine the prevalence of laryngeal and pharyngeal symptoms in patients with environmental inhalant allergy. Methods A retrospective review was conducted of all patients undergoing allergy skin testing between 2006 and 2009. Patients with positive skin tests were included and were classified as ‘mild’ or ‘extensive’ reactors based on skin testing results. Data regarding laryngeal and pharyngeal complaints, as well as ocular and nasal symptoms, had been systematically documented for all patients. The prevalence of these complaints was calculated in each group of reactors and overall. Results The prevalence of laryngeal and pharyngeal complaints was 42.0% overall, 45.5% among the mild reactors, and 39.3% in the extensive reactors. No patients complained of hoarseness or were felt to have dysphonia. There was no statistically significant difference between the mild and extensive reactors (p = 0.78). The prevalence of ocular and/or nasal symptoms was 96.0, 90.9 and 100%, respectively. Conclusion The prevalence of laryngeal and pharyngeal complaints in allergy sufferers was low in this study. Given the conflicting literature on this topic, there is insufficient evidence to establish a causal link between environmental allergy and laryngeal and pharyngeal symptoms. How to cite this article Shah MD, Wise SK, Rotella MR, Ingley AP, Johns MM. Prevalence of Laryngeal and Pharyngeal Symptoms in Patients with Environmental Allergy. Int J Phonosurg Laryngol 2014;4(1):1-4.

Skin testing in allergy

2019 ◽  
Vol 40 (6) ◽  
pp. 366-368
Author(s):  
Gayatri Patel ◽  
Carol Saltoun
Keyword(s):  
Skin Test ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Skin Testing ◽  
Smooth Muscle Contraction ◽  
Skin Tests ◽  
Test Reaction ◽  
Positive Skin ◽  
Intradermal Testing ◽  
Clinical Sensitivity

Skin tests are used in addition to a directed history and physical examination to exclude or confirm immunoglobulin E (IgE) mediated diseases, such as allergic rhinitis, asthma, and anaphylaxis, to aeroallergens, foods, insect venoms, and certain drugs. There are two types of skin testing used in clinical practice: percutaneous testing (prick or puncture) and intracutaneous testing (intradermal). Prick testing involves introducing a needle into the upper layers of the skin through a drop of allergen extract that has been placed on the skin and gently lifting the epidermis up. Various devices are available for prick testing. Intracutaneous (intradermal) testing involves injecting a small amount of allergen into the dermis. The release of preformed histamine from mast cells causes increased vascular permeability via smooth-muscle contraction and development of a wheal; inflammatory mediators initiate a neural reflex, which causes vasodilatation, which leads to erythema (the flare). Prick testing methods are the initial technique for detecting the presence of IgE. These may correlate better with clinical sensitivity and are more specific but less sensitive than intradermal testing. Sites of skin testing include the back and the volar aspect of the arm. By skin testing on the arm, the patient can witness the emergence and often sense the pruritus of the skin test reaction. Because more patients are sensitized (have IgE antibodies and positive skin test reactions) than have corresponding symptoms, the diagnosis of allergy can be made only by correlating skin testing results with the presence of clinical symptoms.

Skin Testing for Penicillin Allergy: Its Limited Value

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 309-309
Author(s):  
Renee K. Bergner
Keyword(s):  
American Academy ◽  
Skin Testing ◽  
Skin Tests ◽  
Penicillin G ◽  
Study Group ◽  
Immediate Hypersensitivity ◽  
Positive Skin ◽  
American Academy Of Pediatrics ◽  
History Of ◽  
Therapeutic Administration

In its statement, "Anaphylaxis," The American Academy of Pediatrics Committee on Drugs states in part: "If there is a possibility of sensitivity to . . . penicillin, skin testing for immediate hypersensitivity to the agent should be performed prior to its therapeutic administration."1 The Penicillin Study Group of the American Academy of Allergy reported in 1971 that only 17 (30.4%) of 56 patients with a history of immediate (including anaphylactic) reactions to penicillin exhibited positive skin tests to penicillin G.2

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