Role of intradermal skin tests in the evaluation of clinically relevant respiratory allergy assessed using patient history and nasal challenges
Authors: Schwindt, Christina D.1; Hutcheson, Patricia S.1; Leu, Szu-Yun2; Dykewicz, Mark S.1
Source: Annals of Allergy, Asthma and Immunology, Volume 94, Number 6, June 2005 , pp. 627-633(7)
Publisher: American College of Allergy, Asthma, & Immunology
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
Abstract:
Background: Skin testing, correlated with patient history, is the accepted method of identifying clinically relevant aeroallergen sensitivity. Traditionally, intradermal tests are believed to be more sensitive in identifying aeroallergen sensitivity than the epicutaneous and percutaneous methods. Therefore, many allergy practitioners use the epicutaneous or percutaneous method first and, if the results are negative, follow up with intradermal tests. Objectives: To compare the epicutaneous, percutaneous, and intradermal methods to determine their sensitivity to patient history and to evaluate the value of intradermal tests when epicutaneous and percutaneous test results are negative. Methods: Participants were evaluated for rhinoconjunctivitis symptoms and then were skin tested using the prick and Multi-Test II (MTII) methods. Intradermal tests were performed when prick and MTII test results were negative to an aeroallergen. Participants with negative prick and MTII test results and corresponding positive intradermal test results underwent nasal challenges with evaluation by anterior rhinomanometry. Results: Compared with patient history, average sensitivity for MTII was 77% and for the prick method was 62%. When MTII results were negative, 17% of intradermal tests corresponded with probable patient histories of allergy but none with positive nasal challenge results. Nasal challenge results were similar to those of the negative control group and significantly different from those of the positive control group (P < .001). Conclusions: The MTII tests are more sensitive and equally specific compared with the prick method. When MTII results are negative, positive intradermal test results are unlikely to identify clinically relevant aeroallergen sensitivity. Routine performance of intradermal tests when MTII results are negative is likely to be of low clinical yield.Document Type: Original article
Affiliations: 1: Division of Allergy and Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, Missouri. 2: General Clinical Research Center, University of California Irvine, School of Medicine, Orange, California.
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
Click here for Page Help