The Study of IgE in the Diagnosis of Allergic Disorders in an Otolaryngology Practice

1979 ◽  
Vol 87 (3) ◽  
pp. 351-358 ◽  
Author(s):  
Donald J. Nalebuff ◽  
Richard G. Fadal ◽  
Majid Ali
Keyword(s):  
Skin Test ◽  
Allergic Disease ◽  
Specific Ige ◽  
In Vitro Assays ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Reaginic Antibody ◽  
Clinically Significant ◽  
Allergic Disorders

Within months after the identification of IgE as the reaginic antibody and principal trigger of immediate hypersensitivity reactions, several radioimmunoassays were developed for its detection in serum. Observations and results obtained with the use of two commercially available in vitro assays in the screening diagnosis of inhalant allergic disease are reported. Over 80% of suspected atopic patients tested had detectable specific IgE to at least two allergens. Both total and specific IgE determinations served useful roles in the recognition of clinically significant allergic disease. Results obtained with these procedures correlate well with information previously obtained only by skin test endpoint titration.

scholarly journals Evaluation of a New Routine Diagnostic Test for Immunoglobulin E Sensitization to Neuromuscular Blocking Agents

2011 ◽  
Vol 114 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Dominique Laroche ◽  
Sylvie Chollet-Martin ◽  
Pierre Léturgie ◽  
Laure Malzac ◽  
Marie-Claude Vergnaud ◽  
...  
Keyword(s):  
Skin Test ◽  
Quaternary Ammonium ◽  
Immunoglobulin E ◽  
Solid Phase ◽  
Specific Ige ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity

Background Neuromuscular blocking agents (NMBA) are responsible for most immediate hypersensitivity reactions during anesthesia, as a result of the presence of a quaternary ammonium ion. The aim of this study was to evaluate the diagnostic performance of a commercial immunoglobulin E (IgE) test (quaternary ammonium morphine [QAM]) for diagnosing sensitivity to NMBA. Methods We tested 168 patients exposed to NMBAs during anesthesia. Of those patients, 54 had an uneventful procedure and 114 had immediate hypersensitivity reactions, and 57 patients had positive skin tests to the administered NMBA, whereas 57 had negative skin tests. Specific IgE concentrations determined with the QAM method based on a morphine solid phase were compared with those obtained with a recommended experimental method with a choline solid phase. Results For the QAM test, a 0.35 kUA/l positivity cutoff was chosen from the receiver operating characteristics curve. QAM-specific IgE was found in 84.2% of skin test-positive reactors (80.7% with the recommended method; no significant difference), and binding was inhibited by the culprit NMBA in 80% of cases. The frequency of QAM-specific IgE positivity was significantly higher in skin test-negative reactors (24.6%) than in controls (9.3%), suggesting NMBA sensitivity. Conclusion Sensitivity of the QAM test (84.2%), together with its simplicity and suitability for routine laboratory use, makes it a valuable tool, in conjunction with skin tests, for diagnosing NMBA sensitivity in patients who react after NMBA injection. The QAM test is of particular interest when skin tests are not available or not reliable or give results poorly compatible with mediator release or clinical features.

Significance of Borderline Levels of Specific IgE obtained by FAST-Plus Assay

1992 ◽  
Vol 106 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Richard L. Mabry ◽  
Cynthia S. Mabry
Keyword(s):  
Skin Test ◽  
Specific Ige ◽  
Skin Tests ◽  
In Vitro Assays ◽  
Test Results ◽  
Positive Skin ◽  
Glycerine Concentration ◽  
Current Standards

The significance of “borderline” levels of allergen-specific IgE as measured by in vitro assays has been questioned. Patients whose specific IgE tests Patients were tested for twelve antigens using the FAST-Plus methodology. All 0/1 results were checked using skin tests at a 1:500 concentration. Positive (histamine) and negative (diluent) controls were used. The antigen-induced wheals were compared with those produced by a control wheal of 2% glycerine (the glycerine concentration in a 1:500 dilution). Positive wheals were arbitrarily considered to be those whose diameter after 10 minutes exceeded that of the glycerine control wheal by 2 mm or more. Using the limits of calibrator fluorescence for the FAST-Plus test in effect before 1990, a significant discordance between skin test results and the class 0/1 in vitro readings was evident. Using the standards in effect since 1990, marked concordance between class 0/1 results and positive skin tests was noted. This was most marked for pollens, less so for molds. Using current standards, FAST-Plus class 0/1 results are best considered positive (pending clinical confirmation), rather than negative.

scholarly journals Histamine and its Release from Nasal Polyps: Preliminary Communication

1984 ◽  
Vol 77 (2) ◽  
pp. 120-124 ◽  
Author(s):  
A B Drake-Lee
Keyword(s):  
Extracellular Fluid ◽  
Specific Ige ◽  
Transmission Electron ◽  
Dust Mite ◽  
Polyp Tissue ◽  
Mixed Grass ◽  
Preliminary Communication ◽  
Ige Mediated ◽  
Allergic Disorders

Two hundred consecutive patients admitted for polypectomy had no evidence of an increased incidence of allergic disorders. Mast cell degranulation was found on transmission electron microscopy and this resulted in considerable quantities of histamine in polyp extracellular fluid (124–7300 ng/ml). RAST levels of allergen-specific IgE to house-dust mite and mixed-grass pollens were raised in 4 out of 28 cases in polyp fluid, and in only one matched serum. In vitro challenge of polyp tissue with allergen extract and anti-IgE suggested an IgE-mediated response in only 4 of 36 patients.

scholarly journals A review on hypersensitivity reactions to fungal aeroallergens in patients with allergic disorders in Iran

2019 ◽  
Author(s):  
Zeinab Nazari ◽  
Javad Ghaffari ◽  
Negar Ghaffari ◽  
Fatemeh Ahangarkani
Keyword(s):  
Allergic Sensitization ◽  
Specific Ige ◽  
Assessment Method ◽  
Hypersensitivity Reactions ◽  
Humid Climate ◽  
The North ◽  
Fungal Allergens ◽  
North Of Iran ◽  
Allergic Disorders ◽  
Fungal Sensitization

Fungal agents account for the clinical manifestation of allergic disorders. The aim of the present study was to review the prevalence of hypersensitivity reactions to fungal aeroallergens in patients with allergic disorders, including allergic rhinitis, asthma, urticaria, and eczema, in Iran. The initial literature search resulted in the identification of 50 records, 26 cases of which met the inclusion criteria. Regarding the methods adopted for the detection of fungal allergens, serum-specific IgE and skin prick tests were used in 6 and 20 studies, respectively. Aspergillus fumigatus and Alternaria alternata sensitization was the most common allergic sensitization among the patients with allergic disorders. According to the reviewed studies, despite the humid climate of the north of Iran, fungal sensitization has a prevalence range of 5-70% in this region. In other regions, such as central and southern Iran, which have a dry and warm climate, fungal sensitization reportedly has a prevalence range of 5-65%. The prevalence of fungal sensitizations varies in different allergic disorders due to the factors related to geographic and genetic issues, gender, sample size, test operator, and assessment method.

Evaluation of a human in vitro skin test for predicting drug hypersensitivity reactions

2019 ◽  
Vol 369 ◽  
pp. 39-48 ◽  
Author(s):  
S.S. Ahmed ◽  
J. Whritenour ◽  
M.M. Ahmed ◽  
L. Bibby ◽  
L. Darby ◽  
...  
Keyword(s):  
Skin Test ◽  
Drug Hypersensitivity ◽  
Hypersensitivity Reactions ◽  
Drug Hypersensitivity Reactions

scholarly journals Assessment of immediate and non-immediate hypersensitivity contrast reactions by skin tests and provocation tests: A review

2021 ◽  
Vol 35 ◽  
pp. 205873842110150
Author(s):  
Rakesh D Bansie ◽  
A Faiz Karim ◽  
Maurits S van Maaren ◽  
Maud AW Hermans ◽  
Paul LA van Daele ◽  
...  
Keyword(s):  
Contrast Media ◽  
Skin Test ◽  
Positive Skin Test ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Positive Skin ◽  
Provocation Tests ◽  
Iodinated Contrast ◽  
Negative Skin Test

Introduction: Allergic and nonallergic hypersensitivity reactions to iodinated contrast media (ICM) and gadolinium-based contrast media are classified as immediate or non-immediate hypersensitivity reactions (IHR and NIHR), respectively. Skin tests and provocation tests are recommended for the evaluation of hypersensitivity reactions to contrast agents; however provocations are not common in clinical practice. Methods: A MEDLINE search was conducted to investigate studies comprising both skin tests and provocation tests that evaluated hypersensitivity reactions to ICM. Results: Nineteen studies were identified that reported on skin tests, followed by provocations. In the case of IHR to ICM, 65/69 (94%) patients with a positive skin test for the culprit media tolerated a challenge with a skin-test-negative alternative ICM. In IHR to ICM with a negative skin test for the culprit media, provocations were positive in 3.2%–9.1% patients. In the case of a NIHR to ICM with a positive skin test, provocation with a skin-test-negative agent was tolerated in 75/105 (71%) of cases. In NIHR with a negative skin test for the culprit agent, re-exposure to the culprit or an alternative was positive in 0%–34.6% patients. Provocations with the same ICM in skin test positive patients with IHR or NIHR were positive for a majority of the patients, although such provocation tests were rarely performed. Data on hypersensitivity reactions, skin tests and provocations with gadolinium-based contrast media were limited; however, they exhibited a pattern similar to that observed in ICM. Conclusion: In both ICM and gadolinium-based contrast media, the risk of an immediate repeat reaction is low when skin tests are negative. In contrast, a provocation with a skin-test-positive contrast medium showed a high risk of an immediate repeat hypersensitivity reaction. Therefore, a thorough medical history is necessary, followed by skin tests. A provocation is recommended, for diagnostic work-up, when the diagnosis is uncertain.

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