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Titolo:
THE FREQUENCY AND CLINICAL-SIGNIFICANCE OF SPECIFIC IGE TO BOTH WASP (VESPULA) AND HONEYBEE (APIS) VENOMS IN THE SAME PATIENT
Autore:
EGNER W; WARD C; BROWN DL; EWAN PW;
Indirizzi:
NO GEN HOSP,DEPT IMMUNOL,SUPRAREG PROT REFERENCE UNIT,POB 894 SHEFFIELD S5 7YT S YORKSHIRE ENGLAND ADDENBROOKES NHS TRUST,DEPT CLIN IMMUNOL CAMBRIDGE CB2 2QQ ENGLAND ADDENBROOKES NHS TRUST,DEPT ALLERGY & CLIN IMMUNOL CAMBRIDGE CB2 2QQ ENGLAND
Titolo Testata:
Clinical and experimental allergy
fascicolo: 1, volume: 28, anno: 1998,
pagine: 26 - 34
SICI:
0954-7894(1998)28:1<26:TFACOS>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
STINGING-INSECT ALLERGY; SKIN-PRICK TEST; SUBCLASS ANTIBODIES; HYMENOPTERA STINGS; NATURAL-HISTORY; CAP SYSTEM; FOLLOW-UP; IMMUNOTHERAPY; HYPERSENSITIVITY; CHALLENGE;
Keywords:
VESPULA; WASP; HONEYBEE; VENOM; ALLERGY; CAP; RAST; SKIN TEST; DIAGNOSIS; CHALLENGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
W. Egner et al., "THE FREQUENCY AND CLINICAL-SIGNIFICANCE OF SPECIFIC IGE TO BOTH WASP (VESPULA) AND HONEYBEE (APIS) VENOMS IN THE SAME PATIENT", Clinical and experimental allergy, 28(1), 1998, pp. 26-34

Abstract

Background Changeover from Phadebas RAST to Pharmacia AutoCAP increased double-positivity to both honey-bet and common wasp (vespula) venomin our patients.Objective We examined the frequency of IgE double-positivity, its clinical relevance and utility in investigating potentially allergic patients. Methods One hundred and eighty-two patients withhymenoptera allergy were tested using PAST (n = 51) and AutoCAP (n = 131) assays over 4 years. Patients had a history of reactions to vespulae (22), honey-bet (10) and unidentified hymenoptera (vespinae) (7). Results After changing from PAST to AutoCAP double-positivity increased from 10 (5/ 51) to 30% (39/131) (P < 0.01). RAST and CAP assays gavesimilar median class results (vespula = 3, honey-bee = 2), Thirty-sixCAP patients had systemic reactions of Mueller grade Il and above. Invespula-allergic double-positive subjects, high CAP classes (greater than or equal to class 3) to honey-bet were common (30%). In 25% the CAP classes were equal. In honey-bee-allergic subjects, all vespula venom CAP IgE was low titre (class 1 or 2) and 20% were equal for both venoms. In 43% of vespinae-allergic patients the CAP class was equal to both (class 2 and 3). In contrast, intradermal skin test double-positivity was uncommon. Double-negative skin test results were common in the CAP double-positive population (22% of honey-bee-allergic. 13% of vespula-allergic and 43% of vespinae-allergic patients). Vespula allergic patients have higher bee-venom IEE than vice versa. Twenty-seven percent of CAP double-positive patients (representing 8% of all venom allergic patients tested over this period) had equal class IgE to both venoms which was not helpful in diagnosis. Combination of skin testing and CAP is unhelpful in only 5/37 (14%) of patients with double-positive serology. Conclusion If used in isolation CAP may be misleading, especially if only one venom is tested. Identification of the causative venom must utilize both clinical history and skin testing in these double-positive patients, and challenge testing if indicated.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/01/21 alle ore 22:57:21