Methacholine challenge is insufficient to exclude bronchial hyper-responsiveness in a symptomatic military population

Stocks, J; Tripp, Michael S.; Lin, Thuy K

doi:10.3109/02770903.2014.919003

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…There is paucity of literature on allergic disorders experienced by military servicemen or pre-enlistees in the Asia-Pacific region. Most of the literature in military medicine describe case reports/series on the epidemiology of insect venom hypersensitivity [ 26 27 28 ], asthma [ 29 ]/exercise-induced bronchoconstriction [ 30 ], anaphylaxis [ 31 32 ], and skin disorders [ 33 34 ]. The literature on therapeutics in allergic diseases in the military covers mostly venom immunotherapy (VIT) and the use of epinephrine autoinjectors in anaphylaxis.…”

Section: Discussionmentioning

confidence: 99%

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Thong

Arulanandam

Tan

et al. 2018

Asia Pacific Allergy

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BackgroundAll Singaporean males undergo medical screening prior to compulsory military service. A history of possible food allergy may require referral to a specialist Allergy clinic to ensure that special dietary needs can be taken into account during field training and deployment.ObjectiveTo study the pattern of food allergy among pre-enlistees who were referred to a specialist allergy clinic to work up suspected food allergy.MethodsRetrospective study of all pre-enlistees registered in the Clinical Immunology/Allergy New Case Registry referred to the Allergy Clinic from 1 August 2015 to 31 May 2016 for suspected food allergy.ResultsOne hundred twenty pre-enlistees reporting food allergy symptoms other than rash alone were referred to the Allergy Clinic during the study period. Of these, 77 (64.2%) had food allergy. Among those with food allergy, mean age was 19.1 ± 1.5 years. They comprised predominantly Chinese (66.2%) and Malays (20.8%). The most commonly reported foods were shellfish/crustaceans (78%), peanut (15.6%), and egg (6.5%). Self-limiting oral allergy syndrome, OAS (itchy lips and throat with/without lip angioedema) was the most common manifestation (n = 33, 42.9%) followed by anaphylaxis (n = 23, 29.9%). Majority of OAS was from shellfish/crustacean (90.6%); of which shrimp (30.3%), crab (15.2%), and lobster (3.0%) were the most common. Mild childhood asthma (69.7%), allergic rhinitis (6.3%), and eczema (6.1%) were the most common atopic conditions among individuals with shellfish/crustacean OAS. This pattern was similar for shellfish/crustacean anaphylaxis. Skin prick tests were most commonly positive for shrimp (OAS 87.1% vs. anaphylaxis 100%), crab (OAS 95.8% vs. 90.9%), and lobster (OAS 91.7% vs. 63.6%).ConclusionOAS to shellfish/crustaceans was more common than anaphylaxis among this study population of young males referred for food allergy symptoms other than rash alone.

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Section: Discussionmentioning

confidence: 99%

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Thong

Arulanandam

Tan

et al. 2018

Asia Pacific Allergy

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“…In the military setting, EIB is associated with military training failure, and has been implicated in death and army discharges (3).…”

Section: Introductionmentioning

confidence: 99%

Role of bronchoprovocation tests in identifying exercise-induced bronchoconstriction in a non-athletic population: a pilot study

et al. 2017

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Background: Studies on diagnostic tests for exercise-induced bronchoconstriction (EIB) have centered around the asthmatic and elite athletic population. Traditionally, the exercise challenge test (ET) was recommended to assess EIB. We aimed to compare the performance of surrogate testing, mainly the hypertonic saline (HS) test, and methacholine challenge test (MCT) versus ET in identifying EIB among non-athletic subjects. Methods:We prospectively recruited subjects who did not have confirmed active asthma, but who reported exercise-induced dyspnoea. The participants underwent HS and ET on separate days within two weeks.MCT performed within one year were obtained retrospectively from medical records. The sensitivity, specificity, and accuracy of each diagnostic test were calculated using ET as the gold standard.Results: We recruited 27 participants (mean age 20.6±2.5 years; 92.6% male). Five (18.5%) had a history of self-reported asthma prior to recruitment. Eleven participants (40.7%) had a positive ET test. The sensitivity, specificity and accuracy of HS in diagnosing EIB was 90.9%, 62.5% and 74.1%; while that of MCT was 88.9%, 83.3% and 85.7% respectively. Six subjects were positive to HS but had negative ET test.Conclusions: Both HS and MCT were found to be suitable alternatives to ET in screening for EIB in the non-athletic population in this pilot study. Further large scale studies are required to confirm this finding.These tests have the potential to replace ET for the diagnosis of EIB in centres without ET equipment or facilities.

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Methacholine challenge is insufficient to exclude bronchial hyper-responsiveness in a symptomatic military population

Abstract: Methacholine challenge is an insufficient screening test to detect bronchial hyper-responsiveness in a symptomatic military population. In military recruits, EIB is associated with training failure.

Cited by 2 publications

References 18 publications

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Role of bronchoprovocation tests in identifying exercise-induced bronchoconstriction in a non-athletic population: a pilot study

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