scholarly journals The skin test with tuberculous recombinant allergen AT successful treated patients with lung tuberculosis

2018 ◽  
Vol 20 (3) ◽  
pp. 17-20
Author(s):  
G S Balasanyants ◽  
N V Skotnikova ◽  
V V Dantsev
Keyword(s):  
Skin Test ◽  
Dynamic Control ◽  
Skin Tests ◽  
Recombinant Allergen ◽  
Positive Skin ◽  
Group 13 ◽  
Group Iii ◽  
Lung Tuberculosis ◽  
Skin Response ◽  
The Moment

38 patients with newly diagnosed tuberculosis, immediately after the end of the main course of treatment, when they were transferred to the third group of dispensary supervision (6-9 months) and when they were removed from the dispensary supervision (2-3 years later), a skin test with an allergen tuberculous recombinant was made. The positive skin test with tuberculosis recombinant allergen was defined at 20 patients - 13 mm. At the moment of removing to the III group only one skin test with tuberculosis allergen recombinant became negative, 19 (94,5%) patients had positive reactions - 13±2,3 mm. At the time of discharging from dispensary the positive reactions were determined at 16 (80%) cases - 10±2,3 mm, p0,05. In this group, 13 (65%) patients had normergic skin tests with tuberculosis allergen recombinant and 7 (35%) - hyperergic tests. At the time of removing to the III group at five from seven patients with hyperergic tests the results remained the same, median and at the moment of discharging from tuberculosis service only one patient had the hyperergic skin test with tuberculosis allergen recombinant - 18mm. Among patients with normergic skin tests with tuberculosis allergen recombinant at the time of group III removing median was 11±2,1 mm. At the last dynamic control the normergic results were determined at 15 (75%) patients and the tests median remained almost unchanged - 10±1,8 mm, the differences are reliable compared to the initial data (p0,05). In group which included 18 patients with negative skin tests with tuberculous allergen recombinant, the skin response stayed negative throughout all examination period except for one patient so patients of this group had not only clinical, radiological and bacteriological, but immunological signs of involution of the tuberculosis process. The study of the influence of clinical, epidemic and social factors to skin reaction showed that first group patients were significantly more likely to be unemployed (30% versus 5,5%; p0,05) whereas in second group married patients were reliably registered (61,1% versus 25%; p0,05). Other factors differed unreliably.

The Importance of Glycerin-Containing Negative Control Tests in Allergy Research Studies that Use Intradermal Skin Tests

2002 ◽  
Vol 127 (3) ◽  
pp. 177-181 ◽  
Author(s):  
David S. Hurst ◽  
Bruce R. Gordon ◽  
John H. Krouse
Keyword(s):  
Skin Test ◽  
False Positive ◽  
Negative Control ◽  
Intradermal Injection ◽  
Skin Tests ◽  
Positive Skin ◽  
Test Response ◽  
Timothy Grass ◽  
Skin Response

OBJECTIVE: We sought to assess skin whealing with glycerin-containing control injections for intradermal skin tests. DESIGN: Observational. METHODS: Wheal sizes were measured at 0, 10, and 15 minutes after intradermal injection of 0.01 and 0.02 mL of phenolated normal saline and 0.5% and 5% concentrations of glycerin in the same quantity of phenolated saline. RESULTS: Intradermal injection of 0.01 mL of phenolated saline produced an average 4.9-mm wheal, which expanded to 5.2 mm at 10 minutes and to 6.0 mm at 15 minutes. Intradermal injection of 0.02 mL of phenolated saline produced a 6.4-mm wheal, which expanded to 7.0 mm at 10 minutes and 8.0 mm at 15 minutes. The addition of glycerin produced proportionally larger wheals. CONCLUSIONS: Because glycerin increases whealing beyond that with phenolated saline, skin tests containing glycerin must be compared with glycerin-containing negative controls. Intradermal skin tests that fail to compare findings in this manner contain an inherent methodologic flaw and are uninterpretable. A major issue in allergy testing is deciding whether the observed skin response is truly indicative of the patient having a clinically relevant, IgE-mediated reaction. 1 Skin test results are influenced by many variables, including patient skin response, specific technique, and tester consistency. Wheal measurement, comparisons with positive and negative control solutions, and interpretation are of equal importance. The development of in vitro methods for allergy diagnosis has helped to independently verify the accuracy of skin tests. In some cases, poor standardization of antigen sources and testing techniques has been shown to lead to discrepancies between skin tests and in vitro IgE antibody results of more than 100-fold. 2 It is also possible for skin tests to be falsely negative, as has been shown by comparing IgE blood tests with both skin tests and challenge tests. 3 Conversely, skin tests may be falsely positive because of nonspecific irritants, such as glycerin, present in allergen solutions. 4,5 Recommendations for immunotherapy must be based on clinical appropriateness as related to valid testing of proposed therapeutic agents. Recent reports by Nelson et al 6 and Wood et al 7 have suggested that skin prick tests (SPTs), even when negative, are sufficiently sensitive to diagnose clinical atopy without the need for further intradermal skin tests (IDTs). Both authors describe performance of a single IDT with injection of 0.02 mL of antigen solution. The basic tenant of their methodology is that all wheals resulting from an IDT measuring 6 mm or greater, accompanied by erythema, are to be recorded as positive. Nelson et al took measurements at 15 minutes, and Wood et al took measurements at an unspecified time. We were concerned that their methodology for IDTs created many false-positive results. This led to the condemnation of IDTs by these authors, stating that “a positive intradermal skin test response to Timothy grass in the presence of a negative skin prick test response to Timothy grass did not indicate the presence of clinically significant sensitivity to Timothy grass.” 6 We found the conclusion based on their particular IDT method to be suspect for 2 reasons: (1) it categorically assumes that an injection of 0.02 would produce a wheal of less than 6 mm and (2) it ignores the effects of small concentrations of the preservative glycerin, used in most all allergy test solutions, on whealing. Either assumption would lead to frequent false-positive skin test interpretations and discredit 60 years of intradermal testing. We therefore sought to evaluate control tests appropriate for use with the methodologies published in the general allergy literature to determine whether a 6-mm wheal with erythema should appropriately be interpreted as a positive or as a negative test.

USE OF THE PERTUSSIS AGGLUTINOGEN SKIN TEST IN A WELL BABY CLINIC

PEDIATRICS ◽  
1951 ◽  
Vol 7 (1) ◽  
pp. 48-52
Author(s):  
NOAH BARYSH
Keyword(s):  
Immune Response ◽  
Skin Test ◽  
Skin Tests ◽  
Effective Agent ◽  
Skin Reactions ◽  
Positive Skin ◽  
Skin Response ◽  
Clinical Protection ◽  
Baby Clinic ◽  
Materials Used

Intradermal skin tests with pertussis agglutinogen were performed on 234 infants. In one group of 100 infants skin tested with this material, at least three months after pertussis prophylaxis, it was found that 92% had positive (immune) skin reactions. In a second group of 134 infants skin tested prior to pertussis vaccination, 83% (111) had negative skin reactions. In 66 of these 111 infants tested after pertussis prophylaxis, 92% developed a positive skin response. The pertussis skin agglutinogen test can be used to determine the efficiency of materials used for pertussis prophylaxis. The pertussis skin agglutinogen test is a reliable indicator of the immune response of an infant to H. pertussis immunization and is recommended as an effective agent for determining the susceptible infant—one lacking the minimal clinical protection against pertussis—after pertussis vaccination.

Penicillin Hypersensitivity

1979 ◽  
Vol 1 (5) ◽  
pp. 132-158
Keyword(s):  
Skin Test ◽  
Multicenter Study ◽  
Positive Skin Test ◽  
Penicillin Allergy ◽  
Skin Tests ◽  
Penicillin G ◽  
Positive Skin ◽  
Positive History ◽  
History Of

A (massive) multicenter study of 3,000 patients has demonstrated that skin tests to penicillin G and penicilloyl-polylysine (PPL-now commercially available) predict and confirm penicillin allergy. Of patients with a history of penicillin reaction, 19% were positive to either, compared to 7% of controls. A history of anaphylaxis led to 46% positive. Of those with a history of urticaria 17% were positive, and those with maculopapular eruptions did not differ from controls (7% positive). Challenge with penicillin led to a reaction in 6% with a positive history (compared to 2% with a negative) and 67% with a combined positive history and positive skin test (to either).

Meglumine antimoniate-induced DRESS: original case with a positive skin test

2018 ◽  
Vol 63 (4) ◽  
pp. 845-847 ◽  
Author(s):  
Amel Chaabane ◽  
Haifa Ben Romdhane ◽  
Hajer Ben Brahim ◽  
Nadia Ben Fredj ◽  
Zohra Chadli ◽  
...  
Keyword(s):  
Skin Test ◽  
Clinical Picture ◽  
Drug Withdrawal ◽  
Skin Tests ◽  
Positive Skin ◽  
Meglumine Antimoniate ◽  
Blood Tests ◽  
Intradermal Tests ◽  
Original Case ◽  
Hepatic Cytolysis

Abstract We report a case of a 64-year-old woman treated with meglumine antimoniate (Glucantime®). On day 20, she developed fever, a pruriginous skin rash and myalgia. The blood tests showed eosinophilia and hepatic cytolysis. The clinico-biological picture improved gradually and the symptoms disappeared 4 weeks after the drug withdrawal. Six weeks later, intradermal tests to Glucantime® were performed and were positive at 48 hour-reading. This clinical picture suggests DRESS induced by meglumine antimoniate. To the best of our knowledge, only one case of meglumine antimoniate-induced DRESS has been reported in the literature and we are the first to report a case confirmed by skin tests.

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.

Neue Charakteristika klinisch manifester Latexallergiker

2019 ◽  
Vol 7 (1) ◽  
pp. 29-31
Author(s):  
Vera Mahler
Keyword(s):  
Medical History ◽  
Skin Test ◽  
Correct Diagnosis ◽  
Natural Rubber Latex ◽  
Specific Ige ◽  
Latex Allergy ◽  
Skin Tests ◽  
Diagnostic Challenge ◽  
Positive Skin ◽  
Significant Difference

Background: Natural rubber latex (NRL) allergy is commonly diagnosed according to medical history, skin allergy tests, and serological analyses. However, skin tests are increasingly being abandoned because of (i) their time-consuming nature, (ii) latex preparations for skin tests being not commercially available, and (iii) the use of in-house prepared test solutions is becoming ever more difficult due to increasing regulatory hurdles. In this light, we have evaluated differences in the profiles of current and former patients with suspected latex allergy. Methods: Sera of skin test-positive patients from a historic cohort (1995-2001, n = 149 patients) and currently (2014-2015, n = 48 patients) were simultaneously analyzed for specific IgE to latex by ImmunoCAP. If the serological screening was positive (≥ 0.35 kU/l), component-resolved diagnostics including profilins and cross-reactive carbohydrate determinants (CCDs) were performed. Results: In contrast to 88% (131/149) of the skin test-positive patients from the 1990s, only 51.1% (24/47) of the current cohort were found positive for specific IgE to latex. While 48.3% (72/149) of the patients had a convincing positive history in the 1990s, current skin test-positive patients rarely reported a relevant medical history (8.5%, 4/47). Specific IgE levels to latex were significantly higher in former patients with suspected latex allergy (p < 0.001) than in former sensitized individuals without allergy. However, this significant difference was lost in current allergic and sensitized patients with positive skin tests. Conclusion: Sensitization profiles in patients with latex allergy have changed significantly over the last 2 decades. Discrimination between NRL sensitization and clinical allergy remains a diagnostic challenge. Our data highlight the need for a combination of all 3 criteria, i.e., patient history, skin test, and analysis of specific IgE, for a correct diagnosis of latex allergy.

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.

scholarly journals Toxoplasma skin- and dye-test surveys of severely subnormal patients in Lincolnshire

1965 ◽  
Vol 63 (1) ◽  
pp. 89-98 ◽  
Author(s):  
J. S. Robertson
Keyword(s):  
Skin Test ◽  
Normal Population ◽  
Congenital Toxoplasmosis ◽  
Mental Deficiency ◽  
Skin Tests ◽  
Adult Males ◽  
Poor Agreement ◽  
Positive Skin ◽  
Epidemiological Surveys ◽  
Epileptic Children

Of 918 severely subnormal patients in mental deficiency hospitals in Lincolnshire 917 were tested by the toxoplasmin skin tests, forty-nine out of 265 patients were dye tested because of a positive skin test or other indication. All patients in another group of 655 subnormals were dye tested, and comparison of these results with those of groups from the normal population showed that in children there was an excess of about 20% of dye-test positivity among the subnormals—a figure identical with that found by Thalhammer in Vienna.The excess of positives became progressively less with increasing age and by middle age the incidence was the same in subnormals as among blood donors in the county. It is suggested that this indicates that patients in hospital are exposed to a lower risk of acquiring infection and that the higher incidence among adult males than among adult female defectives is due to the fact that more of them go out to work, many of them on farms. This factor could also explain the lower incidence of positivity in adult mongols and epileptics who are less commonly employable.Possible explanations of the higher incidence among subnormal than among control children are discussed. Although it is tempting to assume that it indicates that some may be cases of congenital toxoplasmosis, the lack of gradient between child mongols, child epileptics and other subnormal children does not support this hypothesis. The numbers of mongol and epileptic children were too small to give statistically significant results. It is possible that the home environments of severely subnormal children exposed them to a higher risk of infection than did the homes of the control children and that the observed excess of dye and skin-test positivity may be due to increased incidence of acquired infection before their admission to hospital.It was found that there was reasonable concordance between the dye test at a titre of 1/8 and skin sensitivity reactions exceeding 7 mm. in diameter, but poor agreement if 10 mm. was taken as the criterion of positivity.Despite the lesser sensitivity of the skin test, the pattern of the results was the same as that observed in the dye-test survey, and the value of the skin-test for epidemiological surveys was confirmed.

scholarly journals Possibilities of specific immunological tests in patients with TB/HIV coinfection

2021 ◽  
Vol 99 (10) ◽  
pp. 46-51
Author(s):  
L. N. Motanova ◽  
M. S. Grabovskaya ◽  
I. V. Folts
Keyword(s):  
Skin Test ◽  
Skin Tests ◽  
Hiv Positive ◽  
Recombinant Allergen ◽  
Tuberculosis Patients ◽  
Hiv Coinfection ◽  
Immunological Tests ◽  
High Prevalence ◽  
Tuberculosis Disease ◽  
Intensity Of Response

The objective of the study: to study the possibilities of skin tests with tuberculosis recombinant allergen (TRA) in the diagnosis of tuberculosis in HIV-positive patients in the region with a high prevalence of tuberculosis.Subjects and Methods. Medical files of 85 patients were retrospectively analyzed, all the patients suffered from TB/HIV coinfection and underwent the skin test with TRA.Results. The skin test with TRA was found to be significantly valuable for the diagnosis of tuberculosis in patients with TB/HIV coinfection. The correlation between the intensity of response to the TRA test and CD4+ count was detected (p = 0.011). The lowest values were observed for CD4+ counts below 100 cells/μL. The direct correlation between the intensity of response to TRA and the stage of HIV infection was proved. No effect of the form of tuberculosis, the phase of the tuberculosis disease, or drug sensitivity on the intensity of response to TRA was found. Among tuberculosis patients with bacterial excretion (n = 48), 68.8% of patients responded positively to the TRA test, and in those with no bacterial excretion, the positive reaction was observed in 81.1%.

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