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

Abstract

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.

Airway Nitric Oxide in Children with HDM-Induced Allergic Rhinitis

“…12 The NPT protocol was modified using our previous report. 8,13 First, baseline symptoms scores were recorded. Then, nasal airway resistance (NAR) was assessed by anterior rhinomanometry analyses (Multifunctional Spirometer HI-108, Chest M. I., Inc.) and peak nasal inspiratory flows (PNIF) (In-Check Nasal, Clement Clarke).…”

“…house dust mite (HDM) is one of the major causative allergens for allergic children. 7,8 The current study aimed to assess airway NO in children with HDM-induced allergic rhinitis.…”

A Lot Can Happen in a Year

“…The report by Wang et al 5 evaluates expression of protease-activated receptor-2 modulated tight junctions in nasal mucosa via immunohistochemistry and polymerase chain reaction, and advances our understanding of epithelial barrier dysfunction in allergic rhinitis. Traiyan et al 6 use nasal provocation challenge as a reference standard to compare the diagnostic utility of immediate hypersensitivity skin testing and Phadiatop; each method was associated with comparable sensitivity (89.6% vs. 88.6%) and specificity (88.3% vs. 95.3%) for diagnosing allergic rhinitis in a population of children age 5-18. Kahveci et al 7 measured total oxidant status and total anti-oxidant status via blood samples obtained in subjects with allergic rhinitis receiving intranasal steroid monotherapy or combination intranasal steroid and oral antihistamine, and report the combination was associated with decreased total oxidative stress -implying combination therapy may be superior; total oxidant status was also lower in female subjects and in those with seasonal compared with perennial allergic rhinitis.…”

“…Traiyan et al. 6 use nasal provocation challenge as a reference standard to compare the diagnostic utility of immediate hypersensitivity skin testing and Phadiatop; each method was associated with comparable sensitivity (89.6% vs. 88.6%) and specificity (88.3% vs. 95.3%) for diagnosing allergic rhinitis in a population of children age 5-18. Kahveci et al.…”

Immunologic changes after house dust mite modified rush subcutaneous immunotherapy in allergic rhinitis children

“…Rush AIT for inhalant allergen also provides quicker effectiveness with more acceptable reactions than conventional AIT [ 1 ]. House dust mite (HDM) is the most common causative allergen for allergic rhinitis pateints in Southeast Asian countries, especially Thailand [ 6 ]. Patients with HDM allergy can receive HDM subcutaneous or sublingual immunotherapy.…”