Comparison of Skin Tests and RAST for the Diagnosis of Bee Sting Allergy

Patrizzi, R.; Müller, Ulrich; Yman, L.; Hoigné, R

doi:10.1111/j.1398-9995.1979.tb01705.x

Cited by 33 publications

(17 citation statements)

References 10 publications

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“…Six patients (5.3%) had a negative ICST but were sensitized to WV. Such differing results have also been observed by others (20,21). Patrizzi et al.…”

Section: Discussionsupporting

confidence: 66%

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Evaluation of the risk of anaphylactic reactions by wasp venom‐extract challenges in children

Schultze‐Werninghaus

Wahn

Niggemann

1999

Pediatric Allergy Immunology

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Diagnostic sting challenges have been shown to provide information on the risk of further anaphylactic reactions to bee stings. We present a follow-up study in wasp venom-hypersensitive children after diagnostic venom extract challenges to analyze their risk of further anaphylactic reactions. Responses were obtained from 104 patients with wasp venom hypersensitivity out of 115 former patients. Only one of the 104 patients showed more than a severe local reaction to the sting challenge irrespective of the performance of a single or sequential challenge; therefore, only one patient received venom immunotherapy. The performance of a diagnostic sting challenge with wasp venom extract in children had a high negative predictive value of 94.6% for the risk of further systemic reactions. This was shown by analysis of later field stings, since 37 children experienced further field stings and only two of these children(5.4%) developed a mild systemic reaction (urticaria) equal to or less severe than the index sting. The value of the venom extract challenge can be interpreted in two ways: either it is less sensitive than a native sting challenge since the rate of systemic reactions to the challenge was very low, or the prognosis of wasp venom hypersensitivity in children is extremely favorable. Since the latter hypothesis is supported by the low incidence of systemic field sting reactions, we postulate that venom immunotherapy is necessary only in a minority of children with wasp venom hypersensitivity with an index sting reaction of Mueller grade I or II. However, the value of venom extract challenges as a general diagnostic instrument in children with Mueller I and II reactions due to wasp venom hypersensitivity may be questioned. It may have a place as a safe procedure in demonstrating to parents and physicians the often self-limiting natural course in most of these children.

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“…Six patients (5.3%) had a negative ICST but were sensitized to WV. Such differing results have also been observed by others (20,21). Patrizzi et al.…”

Section: Discussionsupporting

confidence: 66%

“…Patrizzi et al. (21) found that 24.3% of 33 BV hypersensitive patients had a positive ICST but no specific IgE. Only one patient had a negative skin test but specific IgE.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the risk of anaphylactic reactions by wasp venom‐extract challenges in children

Schultze‐Werninghaus

Wahn

Niggemann

1999

Pediatric Allergy Immunology

View full text Add to dashboard Cite

show abstract

“…In vitro tests used to detect allergen-specific IgE antibodies in the serum hardly ever identify all skin-test-positive subjects (14)(15)(16). The levels of specific IgE antibody may be too low, or high concentrations of allergen-specific IgG antibodies may interfere with IgE binding (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Detection of mosquito saliva‐specific IgE antibodies by capture ELISA

Brummer‐Korvenkontio

Palosuo

et al. 1997

Allergy

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We developed an IgE-capture ELISA and measured mosquito saliva-specific IgE antibodies in 27 children sensitive to mosquito bites. Children with large 15-min bite wheals had significantly higher (P < 0.0005) mosquito saliva-specific IgE levels than children with small wheals. In the latter group, the saliva-specific IgE level was significantly higher (P = 0.031) than the levels of six infants never exposed to mosquitoes. A positive correlation (r = 0.65; P = 0.0002) was found between the size of the 15-min wheal and the mosquito saliva-specific IgE antibody levels. These results further support the role of mosquito saliva-specific IgE antibodies in the pathogenesis of mosquito-bite whealing. Compared to immunoblotting, IgE-capture ELISA provides a quantitative method to measure mosquito saliva-specific IgE antibodies.

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“…[12][13][14][15][16][17][18] It is generally accepted that a positive intradermal skin test response to insect venom at a concentration of less than or equal to 1.0 mg/mL demonstrates the presence of specific IgE antibodies. [19][20][21][22] Skin testing with fire ant whole-body extract is considered indicative of specific IgE antibodies if a positive response occurs at a concentration of 1:100 wt/vol or less by using the skin prick method or 1:1,000 wt/vol or less by using the intradermal method. 13,14,17 For those patients who have negative skin test responses despite a convincing history of anaphylaxis after an insect sting, especially if they experienced serious symptoms, such as upper airway obstruction or hypotension, it is advisable to consider in vitro testing for IgE antibodies or repeat skin testing before concluding that immunotherapy is not indicated.…”

Section: Executive Summarymentioning

confidence: 99%