KAITAN IgE SPESIFIK METODE IMUNOBLOT TERHADAP ELISA PADA RINITIS ALERGI (Association Between Specific IgE Immunoblot Method with ELISA on Allergic Rhinitis)

Allergic rhinitis is an allergic disease that is most often found beside bronchial asthma and eczema with the prevalence of is about33.3%, 9.8% and 11.2% respectively. The main examinations of allergic rhinitis are Skin Prick Test (SPT) and specific IgE, becausethe sensitivity and specificity of specific IgE examination depend on the examination method. To know the diagnostic value of specificIgE immunoblot examination by determination and were compared with ELISA in patients with allergic rhinitis. The cross-sectionaldesign of the study is con-ducted on patients at the Outpatient Clinic Department of ENT-Head and Neck from May until October 2014.Patients were grouped as diagnosis of allergic rhinitis and non-allergic non-infectious rhinitis based on clinical signs and symptoms,physical examina-tion, positive in SPT examination with or without an increase in total serum IgE and/or blood eosinophils. SpecificIgE immunoblot was conducted by using Foresight®, Acon Laboratories and the ELISA method using Allercoat™. The sensitivity andspecificity of inhalant allergen -specific IgE immunoblot Foresight® method was 73.9% and 42.9%, respectively. The sensitivity andspecificity of inhalant allergen -specific IgE ELISA method was 67.4% and 57.1%, respectively. The results of these two methods havea correlation coefficient 0.531 with p=0.000. The sensitivity and specificity of ingestan allergen specific IgE immunoblot Foresight®method was 41.3% and 85.7%, respectively. The sensitivity and specificity of ingestan allergen specific IgE ELISA method was 17.4 and78.6%, res-pectively. Results of these two methods have a correlation coefficient 0.375 with p=0.003. Based on this study of specificIgE immunoblot and ELISA methods, both have diagnostic sensitivity and specificity, which are almost the same. The sensitivity ofimmunoblot method inhalant allergens are superior to ELISA. The Immunoblot method ingestan allergen specificity is superior toELISA.

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KAITAN IgE SPESIFIK METODE IMUNOBLOT TERHADAP ELISA PADA RINITIS ALERGI

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v21i3.744 ◽

2016 ◽

Vol 21 (3) ◽

pp. 298

Author(s):

Aryati Aryati ◽

Dwi Retno Pawarti ◽

Izzuki Muhashonah ◽

Janti Tri Habsari

Keyword(s):

Allergic Rhinitis ◽

Correlation Coefficient ◽

Sensitivity And Specificity ◽

Clinical Signs ◽

Specific Ige ◽

Total Serum ◽

Inhalant Allergen ◽

Elisa Method ◽

Cross Sectional ◽

Prick Test

Allergic rhinitis is an allergic disease that is most often found beside bronchial asthma and eczema with the prevalence of is about 33.3%, 9.8% and 11.2% respectively. The main examinations of allergic rhinitis are Skin Prick Test (SPT) and specific IgE, becausethe sensitivity and specificity of specific IgE examination depend on the examination method. To know the diagnostic value of specific IgE immunoblot examination by determination and were compared with ELISA in patients with allergic rhinitis. The cross-sectional design of the study is con-ducted on patients at the Outpatient Clinic Department of ENT-Head and Neck from May until October 2014. Patients were grouped as diagnosis of allergic rhinitis and non-allergic non-infectious rhinitis based on clinical signs and symptoms, physical examina-tion, positive in SPT examination with or without an increase in total serum IgE and/or blood eosinophils. Specific IgE immunoblot was conducted by using Foresight®, Acon Laboratories and the ELISA method using Allercoat™. The sensitivity and specificity of inhalant allergen -specific IgE immunoblot Foresight® method was 73.9% and 42.9%, respectively. The sensitivity and specificity of inhalant allergen -specific IgE ELISA method was 67.4% and 57.1%, respectively. The results of these two methods have a correlation coefficient 0.531 with p=0.000. The sensitivity and specificity of ingestan allergen specific IgE immunoblot Foresight® method was 41.3% and 85.7%, respectively. The sensitivity and specificity of ingestan allergen specific IgE ELISA method was 17.4 and 78.6%, res-pectively. Results of these two methods have a correlation coefficient 0.375 with p=0.003. Based on this study of specific IgE immunoblot and ELISA methods, both have diagnostic sensitivity and specificity, which are almost the same. The sensitivity of immunoblot method inhalant allergens are superior to ELISA. The Immunoblot method ingestan allergen specificity is superior to ELISA.

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Allergic Rhinitis

Pediatrics in Review ◽

10.1542/pir.13.9.323 ◽

1992 ◽

Vol 13 (9) ◽

pp. 323-328

Author(s):

Frank S. Virant

Keyword(s):

Allergic Rhinitis ◽

Clinical Signs ◽

Upper Airway ◽

Allergic Patient ◽

The United States ◽

Specific Ige ◽

Interferon Γ ◽

Interleukin 4 ◽

Primary Defect ◽

Primary Focus

Epidemiology Allergic rhinitis affects as many as 8% to 10% of children in the United States. Many of these children suffer significant morbidity, leading to millions of lost school days annually. Morbidity is amplified when these children concurrently suffer from complications of allergic rhinitis, such as recurrent otitis media or chronic sinus disease. Typically, children who have allergic rhinitis have a family history of atopic disorders. Upper airway allergy may become manifest at any age, but the appearance of symptoms is most common during childhood or young adulthood. Clinical signs of rhinitis may be perennial, seasonal, or episodic, and the primary focus of complaints may relate to secondary problems, including ear, sinus, or lung disease. Pathophysiology In the allergic patient, disease is mediated by the production of antigenspecific IgE by the patient's B lymphocytes. Current research suggests that the primary defect may be the excessive production of interleukin 4 (IL-4) or a deficient level of gamma interferon (γ-INF) when a T-cell is presented with an antigen. This constellation of immunomodulators directs the B-cell to produce IgE rather than the IgG response of the non-allergic patient. Clinical disease occurs when an allergen reacts with antigen-specific IgE on the patient's nasal mast cells. When these factors combine, the mast cell is activated to release a variety of preformed and newly produced mediators, including histamine, leukotrienes, and prostaglandins (Fig 1).

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Study of causal aeroallergens in allergic rhinitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192556 ◽

2019 ◽

Vol 5 (4) ◽

pp. 916

Author(s):

Divya Aggarwal ◽

Abhilash S. ◽

Sunil Kapur ◽

Divya Gupta

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

Symptom Score ◽

Eosinophil Count ◽

Severe Disease ◽

Nasal Symptom ◽

Total Serum ◽

Serum Ige ◽

Prick Test ◽

Absolute Eosinophil Count

Background: The diagnosis of allergic rhinitis requires a detailed history, thorough clinical examination and identification of aeroallergens by skin prick test. The diagnosis cannot be confirmed on the basis of symptoms alone because both allergic and non-allergic rhinitis can present with similar symptoms. The present study was undertaken to identify the common aeroallergens causing allergic rhinitis and to find any relationship of the severity of patient’s symptoms with raised levels of absolute eosinophil count, percentage of eosinophils in the peripheral blood and total serum IgE.Methods: It is cross sectional study was conducted among 100 patients including both the genders attending out-patient department of ENT. The patients were divided into mild, moderate and severe disease categories based on nasal symptom score (NSS) which was calculated taking into account the severity of four symptoms namely sneezing, watery rhinorrhoea, itching sensation in nose and nasal obstruction. Results: 76% of patients had moderate nasal symptom score and 42% had symptoms of allergic rhinitis for less than 3 years. The prevalence of skin prick test was strongly positive for pollens (46.19%), followed by dust (16.4%), dust mites (15.7%), fungus (9.7%), insects (9.24%) and epithelia (2.77%). But, among 68 aeroallergens, most common offending allergen was D-farinae (30%). There was no significant relationship found to exist between Eosinophilia, Absolute eosinophil count and serum IgE level with that of nasal symptom score.Conclusions: Skin prick test is the gold standard investigation of choice for definitive diagnosis of allergic rhinitis.

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Skin Prick Test and Serum Specific IgE May Not Be Sufficient for the Diagnosis of Perennial Allergic Rhinitis in Atopic Patients

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2012.12.829 ◽

2013 ◽

Vol 131 (2) ◽

pp. AB41

Author(s):

Miguel Blanca ◽

Carmen Rondon ◽

Paloma Campo ◽

Francisca Gomez ◽

Rosa García Mendoza ◽

...

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

Specific Ige ◽

Perennial Allergic Rhinitis ◽

Prick Test

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Time to Abandon the Serum Cobalamin Level for Diagnosing Vitamin B12 Deficiency

Blood ◽

10.1182/blood.v128.22.2447.2447 ◽

2016 ◽

Vol 128 (22) ◽

pp. 2447-2447 ◽

Cited By ~ 1

Author(s):

Sven R Olson ◽

Thomas G. Deloughery ◽

Jason A Taylor

Keyword(s):

Research Funding ◽

Enterohepatic Circulation ◽

Macrocytic Anemia ◽

Clinical Signs ◽

Signs And Symptoms ◽

Normal Serum ◽

Total Serum ◽

Operating Characteristics ◽

Data Set ◽

B12 Deficiency

Abstract B12 deficiency is a common, reversible cause of macrocytic anemia and neurological symptoms. Suspected B12 deficiency can be evaluated both directly and indirectly using a variety of assays. The serum cobalamin level, despite highly variable sensitivity and specificity, is often the sole test relied upon to diagnose B12 deficiency, despite being influenced by many common medical conditions. B12 levels tend to fall late in deficiency, making it less useful in detecting acute fluctuations in body stores. In addition, assay methodology has proven problematic, with high rates of falsely normal cobalamin levels using newer chemi-luminescent technologies. Most assays also tend to measure total serum cobalamin, notwithstanding the fact that 80% of cobalamin circulates in biochemically inert form. These factors make it difficult to establish thresholds for "normal" serum cobalamin. B12 status exist along a continuous spectrum ranging from subclinically low vitamin concentrations, as observed in vegans who maintain a system of enterohepatic circulation, to fulminant deficiency with severe clinical signs and symptoms. Serum cobalamin <200 pg/mL is a threshold commonly used to delineate true deficiency, though such low levels are infrequently observed. Methylmalonic acid (MMA), a molecular intermediate in a unique metabolic pathway requiring cobalamin as a cofactor, can be also be used to assess B12 status. MMA reflects tissue availability of biochemically active cobalamin rather than total cobalamin, with an excellent sensitivity. Fluctuations in MMA occur rapidly, and are detectable in the setting of subtle neurologic, psychiatric or hematologic signs and symptoms when corresponding serum cobalamin levels may remain normal. False positive MMA can be seen in renal dysfunction, though typically to a far milder degree than true deficiency. To explore the operating characteristics of these serum tests in detecting clinical B12 deficiency, we retrospectively identified all MMAs measured at our institution over the 2015 calendar year and compared any elevated values with corresponding serum cobalamin levels drawn within the same week. 34 of 42 (81%) elevated MMAs were associated with a serum cobalamin level within our laboratory's reference range, and six (14%) of these were actually greaterthan the upper limit of normal. Acknowledging the limited size of our data set, this translates to a 19% sensitivity of serum cobalamin for detecting elevations in MMA and, by extrapolation, detecting clinical B12 deficiency. This sensitivity is far lower than that commonly reported in the literature. Despite the superior test characteristics of MMA, serum cobalamin is often the first and only test performed to evaluate B12 status due to "economic" reasons or force of habit. If only the cobalamin level were relied upon, many patients would go untreated for a curable disease. While the cost difference of serum cobalamin and MMA assays at our hospital ($7.00 and $18.00, respectively) is not negligible, the time and expense of repeated cobalamin measurements or other testing necessary to accurately diagnose B12 deficiency is arguably greater. The mass of accumulated data shows that serum cobalamin is an insensitive assay for B12 deficiency and should be abandoned. MMA is superior for detecting diminished functional B12 stores; increased utilization of this test will result in more accurate and cost-efficient diagnosis of true B12 deficiency. Disclosures Taylor: Baxalta/Shire: Consultancy, Research Funding; Novo Nordisk: Research Funding; Kedrion: Research Funding; CSL Behring: Consultancy, Research Funding.

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Soy Skin Prick Test in Patients with Physician-Diagnosed Atopic Disorders

QJM ◽

10.1093/qjmed/hcaa063.007 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

S M Reda ◽

N M Radwan ◽

H R Abdelghany

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

Soy Protein ◽

Total Serum ◽

Positive Skin Prick Test ◽

Positive Skin ◽

Female Ratio ◽

Serum Ige ◽

Prick Test ◽

Protein Sensitization

Abstract Background Soy protein is an important component of soybeans and is one the 8 most significant food allergens. Yet, the prevalence of soy allergy in the pediatric population is not well defined. Objectives To evaluate the incidence of IgE mediated soy protein sensitization among children with clinical manifestation of atopic disorders by the use of skin prick test (SPT) for soy protein. Methods Two hundred patients with atopic manifestations attending the Pediatric Allergy and Immunology Clinic at the Pediatric Department of Ain shams University, were recruited between January 2017 till January 2018. They were subjected to SPT to soy protein, measurement of total serum IgE and eosinophilic count in the peripheral blood. Results Of the 200 patients, 108 (54%) were males and 92 (46%) were females with a male to female ratio of 1.17:1. Their ages ranged between 2 years and 15 years (mean±SD; 6.0±33.3 years). Seven patients (3.5%) had positive skin prick test to soy protein. The mean value for the absolute eosinophilic count was 0.4x109/L. The median for the total serum IgE level was 50 IU/L. According to age, the highest percentage of soy protein sensitivity was elicited among patients less than 3 years (57.14%), followed by those between 3 to 6 years (28.5%) and those between 6 and 15 years (14.28%). A positive family history of atopy was recorded in 122 (61%) of all cases. In terms of gender, incidence of soya sensitivity was higher among males than females but with no statistical difference. Although the most common allergic manifestations of all studied patients were respiratory (83%), and atopic dermatitis (22.5%), yet positive SPT to soy proteins was elicited in 43% in allergic rhinitis cases, in 29% of asthma patients, in 14% of patients with combined asthma and allergic rhinitis, and 14.3% of patients having eczema. Conclusion Soy protein sensitization is not uncommon in children especially in those with atopic manifestations. Large scale studies are needed to evaluate the actual incidence of soy protein hypersensitivity in children.

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Hyperbilirubinemia as a predictor of the severity of acute appendicitis - an observational study

International Surgery Journal ◽

10.18203/2349-2902.isj20171138 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1341 ◽

Cited By ~ 1

Author(s):

Sadhan Kumar Cheekuri ◽

Alok Mohanty ◽

T. Ganesh ◽

R. Kannan ◽

Robinson Smile

Keyword(s):

Observational Study ◽

Acute Appendicitis ◽

Serum Bilirubin ◽

Clinical Signs ◽

Signs And Symptoms ◽

Complicated Appendicitis ◽

Total Serum ◽

P Value ◽

Predictive Capacity ◽

Computed Tomography Scanning

Background: Appendicitis is the most common acute abdominal condition requiring emergency surgery, with a lifetime risk of 6%. Appendectomy continues to be one of the commonest procedures in general surgery, accounts for approximately 1% of all surgical operation. Despite the increased use of ultrasonography, computed tomography scanning and laparoscopy, the rate of misdiagnosis of appendicitis has remained constant (15.3%). The aim of this study was to whether Serum Bilirubin can be considered as a new laboratory marker to aid in the diagnosis of acute appendicitis and if so, does it have the predictive capacity to warn us about complicated appendicitis.Methods: This was prospective observational study done in Mahatma Gandhi Medical College and Research Institute, Pondicherry between November 2014 and August 2016. About 110 patients of acute appendicitis who had undergone appendicectomy were studied. Data was collected and analyzed critically.Results: Males 66 (60%) outnumbered females 44 (40%) and overall mean age was 26.61±12.37 years. Of the 110 patients, 9% were normal appendix, 59.09% were confirmed as acute appendicitis while 31.81% were diagnosed with complicated appendicitis on biopsy. The Sensitivity and Specificity of serum bilirubin as a marker in predicting Acute appendicitis and complicated appendicitis was 47.6% and 90.9% respectively. Similarly, the Positive predicative value and Negative predicative value for the same was 88.5% and 61.5% respectively with odds ratio 12.4 with significant p value <0.0001.Conclusions: Serum bilirubin is easily available test and cheap and can be estimated from the sample of blood drawn for routine blood investigations. Patients with clinical signs and symptoms of appendicitis and with hyperbilirubinemia should be identified as having a higher probability of complicated appendicitis. Hence, serum bilirubin levels have a predictive potential for the diagnosis of severity of acute appendicitis and need for early appendicectomy. If total serum bilirubin is added to already existing laboratory tests, then the diagnosis of complicated appendicitis in clinically suspected cases can be made with fair degree of accuracy, the need for CECT and MRI can be reduced and unnecessary delay in appendicectomy can be avoided.

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Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children

American Journal of Rhinology and Allergy ◽

10.1177/1945892420938300 ◽

2020 ◽

Vol 35 (1) ◽

pp. 98-106

Author(s):

Sasiwimon Traiyan ◽

Wiparat Manuyakorn ◽

Watcharoot Kanchongkittiphon ◽

Cherapat Sasisakulporn ◽

Wanlapa Jotikasthira ◽

...

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

Provocation Test ◽

Specific Ige ◽

Prick Test ◽

The Past ◽

Negative Results ◽

Dust Mite ◽

The Mean ◽

Positive Results

Background Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. Objective To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. Methods Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. Results One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. Conclusions SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.

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