Systemic reactions to allergy skin tests

Valyasevi, Mickey A.; Maddox, Daniel E.; Li, James T.C.

doi:10.1016/s1081-1206(10)62624-5

Cited by 99 publications

(60 citation statements)

References 15 publications

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“…25 O método usado para confirmação diagnóstica 27 Sugere-se, ainda, que pode haver relação direta quantitativa entre classe do ImmunoCAP e gravidade dos sintomas apresentados, como urticária, asma e rinoconjuntivite. 28 A grande desvantagem do UniCAP ® é o alto índice de resultados falso-negativos, podendo atingir 25%.…”

Section: Discussionunclassified

Alergia ao látex em profissionais de saúde de São Paulo, Brasil

Montalvão

Pires

Mello

2008

An. Bras. Dermatol.

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Resumo: FUNDAMENTOS -Alergia ao látex é comum em trabalhadores da saúde, resultando em absenteísmo e afastamento das atividades profissionais. Há no Brasil poucos estudos publicados sobre o assunto. Enquanto na população geral a prevalência de alergia ao látex é menor que 2%, nos profissionais de saúde pode chegar a 30%. OBJETIVO -Estudar a prevalência de alergia ao látex em profissionais de saúde do Hospital do Servidor Público Estadual de São Paulo. MÉTODOS -Foi aplicado questionário aberto a profissionais que têm contato com luvas de borracha em todos os serviços do hospital. Foi colhido sangue daqueles que referiram sintomas e dosado anticorpo IgE específico por meio do ImmunoCAP. Para análise estatística utilizaram-se porcentagens, tabelas e teste qui-quadrado. RESULTADOS -Foram distribuídos 2.349 questionários, e respondidos 1.045, dos quais 129 referiram correlação entre uso de látex e sintomas sugestivos de alergia, e 54 permitiram a coleta de sangue para determinação de IgE específica. Neste grupo houve dois casos em que foi demonstrado anticorpo específico, estabelecendo-se prevalência de 3,7% de alergia ao látex. Fatores como gênero, profissão, freqüência de contato com luvas, setor de trabalho e antecedentes de atopia foram relacionados com maior prevalência de alergia ao látex. CONCLUSÃO -A prevalência de alergia ao látex encontrada foi de 3,7%. Palavras-chave: Epidemiologia; Hipersensibilidade ao látex; Hipersensibilidade imediata ; Látex Abstract: BACKGROUND -Latex allergy is common among healthcare workers and leads to absence

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Section: Discussionunclassified

Alergia ao látex em profissionais de saúde de São Paulo, Brasil

Montalvão

Pires

Mello

2008

An. Bras. Dermatol.

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“…The risk of systemic reactions by skin testing with penicillins, according to published data, was compared to the risk in allergic patients tested for common respiratory and food allergens [5,23,24]. When possible, the prevalence of general reactions was gauged separately for different groups of patients and sorted by different criteria of selection: (1) patients with no history of adverse reactions to penicillins or general population not screened; (2) patients with history of suspected adverse reactions to penicillin or other β-lactams; (3) patients with true allergic sensitization to penicillins proved by positive skin tests; (4) patients with history of anaphylaxis or severe systemic allergic reactions [21,22] (group at higher risk of systemic reaction by skin testing) [3].…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have consistently suggested that this practice carries a higher risk of systemic reactions, as compared to skin tests with standardized common food- or aeroallergens. This is especially true for patients with a clinical history of generalized or severe adverse reactions [1,5,6,7,8,9,10]. When performing skin tests for penicillin and other β-lactams, established safety procedures must be adopted, and ready access to emergency treatment should be available [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, the magnitude of the risk is largely variable across studies [5,6,7,8,9,10,12], and very severe reactions or death have only been reported anecdotally [13,14,15,16,17,18]. Thus, it seems that the routine hospitalization of patients who undergo skin tests for antibiotics is a result of authorities being overly precautious, rather than a necessary safety or organizational requirement.…”

Section: Introductionmentioning

confidence: 99%

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Risk Assessment of Immediate Systemic Reactions from Skin Tests with β-Lactam Antibiotics

Antico¹,

Pagani²,

Compalati

et al. 2011

Int Arch Allergy Immunol

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Background: Some clinical studies have demonstrated that skin tests for β-lactam antibiotics may cause more adverse reactions than skin tests for common allergens. Objective: To assess the risk of systemic reactions from penicillin skin testing, based on a pre-test categorization of patients, in order to establish an appropriate strategy for preempting and dealing with cases. Methods: A case series of 175 patients with a suspected allergy to penicillin was reviewed, and patients were classified as having a low or high probability of allergic sensitization to penicillin, according to their clinical history. For every group, the rate and the increase in the relative risk (RRI) of systemic reactions by skin testing were calculated. The results were compared to those reported in the available literature. Results: In our case series of 175 patients, 52 were classified as having a high probability of being allergic to penicillin, according to their clinical history. Five systemic reactions to skin testing were observed, and these were exclusively in this group (9.61%, RRI = 479). In agreement with the literature, patients with a high likelihood of penicillin allergy showed an increase of up to 10% in the occurrence of systemic reactions at skin testing; in patients who had had severe allergic reactions, this figure was up to 20%. Conclusions: The RRI of systemic reactions by skin testing is proportional to the pre-test probability of a true immediate hypersensitivity reaction to β-lactam antibiotics. In the present case series, only patients with high pre-test probability were at risk, and this group should therefore be skin tested and monitored in a hospitalization regimen, where resuscitation staff and access to an emergency room are immediately available.

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“…In a survey of 16,000 individuals tested with eight routine allergens, the rate of adverse reactions was 0.04% 31 but most of these were syncope, near-syncope or malaise. In another large survey, the rate of systemic allergic reactions was 0.033%, all occurring in asthmatics 32 . A small number of fatalities are recorded as a result of intradermal skin tests; there is only one reported fatality from skin prick testing (however this was an atypical case and many of the risk factors mentioned below were present) 14 .…”

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confidence: 94%

Microgeographic factors and patterns of aeroallergen sensitisation

Kam

Tong

Christensen

et al. 2016

Medical Journal of Australia

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Objective: To examine patterns of airborne allergen (aeroallergen) sensitisation in the Greater Sydney area (Sydney), and their relationships with climate, coastal proximity and environment (urban v regional). Design, setting, participants: Retrospective cross‐sectional study of patients who underwent aeroallergen skin prick testing at three Sydney allergy clinics, January 2001 – October 2014. Main outcome measurements: Proportions of patients sensitised to specific aeroallergen types; relationships between sensitisation patterns and climate and geography. Results: Of 1421 patients who met the selection criteria (mean age, 28.3 years [SD, 21.3]; 53.3% were female), 1092 (76.8%) were sensitised to at least one aeroallergen. Those living less than 15 km from the coast were less commonly sensitised to cockroach (< 15 km, 15.1%; 15–30 km, 40.0%; > 30 km, 39.7%; P < 0.001) and grass aeroallergens (< 15 km, 36.5%; 15–30 km, 52.2%; > 30 km, 58.1%; P < 0.001) than patients further inland; the same applied to mould, weed and tree aeroallergens. Subtropical grass sensitisation was more common in temperate/warm summer climates (about 50%) than in temperate/hot summer (27.1%) or subtropical climates (15%) (P < 0.001), and less common in urban (36.7%) than in regional areas (54%; P = 0.014). 72.4% of grass‐sensitised patients were co‐sensitised to both temperate and subtropical grasses. A selected ten‐aeroallergen skin prick test panel identified 98.5% of atopic patients in this Sydney sample. Conclusions: Environmental and geographic factors are associated with different patterns of allergic sensitisation in Sydney. Extensive co‐sensitisation to subtropical and temperate grasses has implications for immunotherapy in Australia, where most currently available therapies are based on formulations directed at temperate grasses only.

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Systemic reactions to allergy skin tests

Cited by 99 publications

References 15 publications

Alergia ao látex em profissionais de saúde de São Paulo, Brasil

Alergia ao látex em profissionais de saúde de São Paulo, Brasil

Risk Assessment of Immediate Systemic Reactions from Skin Tests with β-Lactam Antibiotics

Microgeographic factors and patterns of aeroallergen sensitisation

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