Concordance of Skin Prick Test, Intradermal Testing, Serum IgE Levels and Symptoms in Patients with Allergic Rhinitis

Background: Diagnosis of allergic rhinitis is achieved by a combination of patient history and different screening tools, followed by specific provocation testing. Screening tools usually involve a skin prick test (SPT), specific serum IgE or a combination of both. Objective: The purpose of this study was to evaluate the correlation of SPT, intradermal testing and specific serum IgE testing in certain allergens and to evaluate sensitization rates, symptom patterns and time of symptoms in a cohort of patients with suspected allergic rhinitis. Methods: Data on 4653 patients with suspected allergic rhinitis were included and divided into five groups: spring bloomers (birch, hazel, etc.), summer bloomers (grasses and rye), autumn bloomers (ribwort and mugwort), mites and mold. Correlation of SPT, intradermal testing and specific IgE test results using Cohen’s kappa and logistic regression were carried out to evaluate the probability of symptoms. Results: Comparison of SPT and specific serum IgE led to kappa coefficients between 0.33 and 0.47, corresponding to a minor to moderate concordance. Comparing the symptoms reported by patients with sensitization diagnosed by SPT, a correlation was only found for spring and summer bloomers with an odds ratio of 1.5 and 2.1, respectively. The most prevalent symptom in the study cohort was rhinitis, followed by others such as asthma, sense of smell and atopic dermatitis. Conclusions: SPT seems to be more sensitive than specific IgE for detection of sensitization. Patients’ symptoms as well as the timing of symptoms, especially for perennial allergies, are not always very pronounced.

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The correlation between intradermal testing and serum specific IgE to house dust mite in negative skin prick test allergic rhinitis adult patients

Asian Pacific Journal of Allergy and Immunology ◽

10.12932/ap0579.33.4.2015 ◽

2015 ◽

Vol 33 (4) ◽

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

House Dust ◽

House Dust Mite ◽

Specific Ige ◽

Adult Patients ◽

Intradermal Testing ◽

Prick Test ◽

Dust Mite ◽

Negative Skin Prick Test

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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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Comparison of fiberglass-based histamine assay with a conventional automated fluorometric histamine assay, case history, skin prick test, and specific serum IgE in patients with milk and egg allergic reactions

Allergy ◽

10.1111/j.1398-9995.1993.tb02174.x ◽

1993 ◽

Vol 48 (1) ◽

pp. 49-53 ◽

Cited By ~ 5

Author(s):

J. Kleine-Tebbe ◽

S. Werfel ◽

D. Roedsgaard ◽

H. Nolte ◽

P. S. Skov ◽

...

Keyword(s):

Skin Prick Test ◽

Case History ◽

Allergic Reactions ◽

Serum Ige ◽

Prick Test ◽

Specific Serum

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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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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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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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Comparison between Specific Immunoglobulin E and Skin Prick Test for Diagnosis of Allergic Patients

10.51429/ejmm29422 ◽

2020 ◽

Vol EJMM29 (4) ◽

pp. 173-179

Author(s):

Wafaa S. Metwally ◽

Ghada A. Mokhtar

Keyword(s):

Skin Prick Test ◽

Immunoglobulin E ◽

Diagnostic Yield ◽

Good Alternative ◽

Specific Ige ◽

Gold Standard Method ◽

Serum Ige ◽

Prick Test ◽

Serum Total Ige

Background: Skin prick test (SPT) has been identified as the gold standard method to diagnose IgE mediated hypersensitivities; it is accurate, easy and cheap. However, SPT has some important limitations, so in vitro serum specific serum IgE (sSIgE) detection can be a good alternative. The diagnostic yield of sSIgE testing usually depends on the specific allergen. Objective: This study compares between SPT and sSIgE for diagnosis of allergy. Methodology: 61 allergic patients enrolled from Zagazig University Allergy and Immunology Unit, tested by SPT for the common allergens. Serum total IgE and specific IgE levels were measured and compared to SPT results. Results: The over- all sensitivities of sSIgE were excellent (75-100%) for most of allergens tested. PPV was excellent with some allergens (pollens, cockroaches, mites) and poor with others (cat hair). Sensitivity of mites sSIgE was excellent with PPV approaching 90%, specificiy was only 13%. However, the NPV was 100%. Significant level of agreement and correlation between the results of SPT and sSIgE for cockroaches and molds was reported. Positive correlation between the total levels of serum IgE and the diameter of wheal and flare of the SPT for mites, pollens and cockroaches was found. Conclusion: The sensitivities of sSIgE were excellent for most of allergens tested. Specificity of sSIgE varies between individual allergens. Serum specific IgE testing may be a good alternative to skin prick test if the latter could not be carried out.

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