Skin Prick Testing to Aeroallergen Extracts: What Is the Optimal Panel in Children and Adolescents in Turkey?

Şahiner, Ümit Murat; Civelek, Ersoy; Yavuz, Süleyman Tolga; Büyüktiryaki, Ayşe Betül; Tuncer, Ayfer; Şekerel, Bülent Enis

doi:10.1159/000329870

Cited by 52 publications

(55 citation statements)

References 32 publications

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“…In our pediatric allergy department, we have performed SPTs with the Stallerpoint instrument (with 90° clockwise rotation) for more than 5 years [12]. Following the published article by Masse et al [9] that questioned the value of the Stallerpoint device in adult patients, we organized this study to expand the findings to the use of the device in children.…”

Section: Discussionmentioning

confidence: 99%

Optimizing the Use of a Skin Prick Test Device on Children

Büyüktiryaki¹,

Şahiner²,

Karabulut

et al. 2013

Int Arch Allergy Immunol

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Background: Studies comparing skin prick test (SPT) devices have revealed varying results in performance and there is little known about their use on children. Methods: We performed 2 complementary studies to test the sensitivity, reproducibility and acceptability of commercially available SPT devices (Stallerpoint, Antony, France) using different application techniques. In the first part, histamine/saline was put on as a drop by use of a vial (V), and in the second part it was transferred from a well with the aid of the test device (W). The techniques were as follows: apply vertical pressure (Stallerpoint-VP or Stallerpoint-WP), apply vertical pressure with 90° clockwise rotation (Stallerpoint-VC or Stallerpoint-WC) and apply vertical pressure with 90° clockwise and counter-clockwise rotations (Stallerpoint-VCC or Stallerpoint-WCC). For comparison, ALK Lancet was used with a technique of ‘drop and apply vertical pressure'. Results: In the first part, sensitivities of the Stallerpoint-VC (96.6%), Stallerpoint-VCC (95.5%) and ALK Lancet (93.2%) techniques were superior (p < 0.001) to the other Stallerpoint-VP and Stallerpoint-WP techniques (76.1 and 46.6%). Intrapatient coefficient of variation (CV) values were 15.0, 18.9, 15.4, 22.4 and 48.5%, respectively. Interpatient CV ranged between 22.8 and 55.1%. In the second part, the Stallerpoint-WC (98.8%), WCC (97.5%) and ALK Lancet (98.8%) techniques yielded high sensitivities, whereas the sensitivity of Stallerpoint-WP (28.7%) was very low. There were false-positive reactions in the Stallerpoint-VCC and WCC techniques. Conclusion: In children, the SPT technique was found to be as important as the testing device. Stallerpoint-VC and WC techniques are reliable, tolerable and comparable with the ALK Lancet technique.

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Section: Discussionmentioning

confidence: 99%

Optimizing the Use of a Skin Prick Test Device on Children

Büyüktiryaki¹,

Şahiner²,

Karabulut

et al. 2013

Int Arch Allergy Immunol

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“…All participants were also skin prick tested for aeroallergens common to our region along with histamine and negative controls [13]. The tests were applied on the volar surface of both forearms and recorded after 15 min and considered as positive if the mean wheal diameter was ≥3 mm compared to the negative control.…”

Section: Methodsmentioning

confidence: 99%

Clinical Features of Children with Venom Allergy and Risk Factors for Severe Systemic Reactions

Yavuz

Şahiner²,

Büyüktiryaki³

et al. 2012

Int Arch Allergy Immunol

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Background: Severe systemic reactions (SRs) to insect venom are rare in childhood and there are few data on this study population. The aim of our study is to analyze the clinical features and to document the risk factors for severe SRs in children with insect venom allergy. Methods: Children with SRs after Hymenoptera sting were analyzed. The diagnosis was based on medical history, skin tests and/or specific IgE testing. Results: Seventy-six children were included [57 boys (75%), mean age 9.8 ± 3.4 years]. The mean age of children at the time of SR was 8.3 ± 3.4 years. Reactions were accounted for Vespula (wasp) venom in 58 (76%) and Apis mellifera (bee) venom in 18 (24%) patients. Twenty-six percent of patients had aeroallergen sensitization and 33% had atopic disease, whereas 66% had experienced previous stings. The upper limb was the most frequent area of sting (43%), and the cutaneous system (99%) was the most frequent involved system. SRs occurred in 59% of patients. Multivariate logistic regression analysis revealed eosinophilia (>5%) [odds ratio (OR) 12.6; confidence interval (CI) 1.5–109.7; p = 0.022], female sex (OR 6.4; CI 1.5–26.9; p = 0.011) and accompanying atopic disease (OR 3.4; CI 1.2–12.3; p = 0.016) as significant risk factors for severe SRs. Ninety-seven percent of patients were admitted to the emergency department; however, epinephrine was used in only 46% of patients. Conclusions: There was a high frequency of hypersensitivity to wasp venom among the study population, and severe reactions were related to mild eosinophilia, female sex and concomitant atopic diseases. A better understanding of the risk factors may lead to effective utilization of health care sources in the future.

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“…Ülkemizde ev içi allerjenlerden en sık ev tozu akarı, dış ortam allerjenlerinden ise en sık çayır poleni duyarlılığı saptanmaktadır. Her yaş grubunda güvenle yapılan bu testler aeroallerjen duyarlılığının gelişimi için gereken süre nedeniyle 2 yaştan sonra kullanılmaktadır (26,27).…”

Section: Taniunclassified

“…Nazal sekresyonlardaki artış ile eozinofil sayısı arasında ilişki olduğu gös-terilmiştir. Tüm bu değişikliklere nötrofil artışının da eşlik etmesi ve eozinofilinin diğer pek çok durumda da izlenmesi, sitolojik değişikliklerin AR için belirleyiciliğini azaltmaktadır (26)(27)(28)(29)(30).…”

Section: Taniunclassified