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Correlation of skin test results and specific immunoglobulin E blood levels with nasal provocation testing for house-dust mite allergies.
Am J Rhinol Allergy. 2016 Jan-Feb; 30(1):60-4.AJ

Abstract

BACKGROUND

Allergen-specific immunotherapy for house-dust mite (HDM) allergies is associated with lower success rates when compared with similar treatments for other inhalant allergens, such as grass or birch. One reason might be the greater difficulty in diagnosing patients with assumed HDM allergies because symptoms occur perennially and may differ from those of a conventional allergic rhinitis.

OBJECTIVE

The aim of the study was to compare the different methods of diagnosis in patients with assumed HDM allergy.

METHODS

We performed a retrospective analysis of nasal provocation tests (NPT) from patients (n = 161) evaluated for Dermatophagoides pteronyssinus (n = 127) and Dermatophagoides farinae (n = 104) allergies, and compared the results with other allergen testing methods (skin-prick test [SPT], intracutaneous test, and allergen specific immunoglobulin E levels [sIgE] to detect sensitization). Receiver operating characteristic curves were used for the analyses and the areas under the curve were calculated.

RESULTS

For D. pteronyssinus and D. farinae, 86 and 70 complete data files, respectively, were available. For both tested HDMs, the results of the receiver operating characteristic curves showed a significant correlation for SPT and sIgE, with the results of the NPT (area under the curve, 0.742 to 0.763) but not for the intracutaneous test. In patients with a positive SPT (≥3 mm), an allergy was confirmed by the NPT in 69% of cases for D. pteronyssinus and 71% for D. farinae. A positive sIgE result (ImmunoCAP class of ≥2) was verified by the NPT in 69% of cases (D. pteronyssinus) and 70% (D. farinae).

CONCLUSION

The predictability value for a positive NPT result is best for SPT and sIgE. Nevertheless, even if the results of both test systems are combined, the positive predictive value that was achieved was only 0.77 for D. pteronyssinus and 0.69 for D. farinae. Therefore, in patients eligible for immunotherapy for HDM, an NPT should be performed before the start of the therapy to verify a clinically relevant allergy.

Authors+Show Affiliations

Department of Otorhinolaryngology, Head and Neck Surgery, AMEOS Klinikum Haldensleben, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26867532

Citation

Haxel, Boris R., et al. "Correlation of Skin Test Results and Specific Immunoglobulin E Blood Levels With Nasal Provocation Testing for House-dust Mite Allergies." American Journal of Rhinology & Allergy, vol. 30, no. 1, 2016, pp. 60-4.
Haxel BR, Huppertz T, Boessert P, et al. Correlation of skin test results and specific immunoglobulin E blood levels with nasal provocation testing for house-dust mite allergies. Am J Rhinol Allergy. 2016;30(1):60-4.
Haxel, B. R., Huppertz, T., Boessert, P., Bast, F., & Fruth, K. (2016). Correlation of skin test results and specific immunoglobulin E blood levels with nasal provocation testing for house-dust mite allergies. American Journal of Rhinology & Allergy, 30(1), 60-4. https://doi.org/10.2500/ajra.2016.30.4262
Haxel BR, et al. Correlation of Skin Test Results and Specific Immunoglobulin E Blood Levels With Nasal Provocation Testing for House-dust Mite Allergies. Am J Rhinol Allergy. 2016;30(1):60-4. PubMed PMID: 26867532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation of skin test results and specific immunoglobulin E blood levels with nasal provocation testing for house-dust mite allergies. AU - Haxel,Boris R, AU - Huppertz,Tilman, AU - Boessert,Patrick, AU - Bast,Florian, AU - Fruth,Kai, PY - 2016/2/13/entrez PY - 2016/2/13/pubmed PY - 2016/12/15/medline SP - 60 EP - 4 JF - American journal of rhinology & allergy JO - Am J Rhinol Allergy VL - 30 IS - 1 N2 - BACKGROUND: Allergen-specific immunotherapy for house-dust mite (HDM) allergies is associated with lower success rates when compared with similar treatments for other inhalant allergens, such as grass or birch. One reason might be the greater difficulty in diagnosing patients with assumed HDM allergies because symptoms occur perennially and may differ from those of a conventional allergic rhinitis. OBJECTIVE: The aim of the study was to compare the different methods of diagnosis in patients with assumed HDM allergy. METHODS: We performed a retrospective analysis of nasal provocation tests (NPT) from patients (n = 161) evaluated for Dermatophagoides pteronyssinus (n = 127) and Dermatophagoides farinae (n = 104) allergies, and compared the results with other allergen testing methods (skin-prick test [SPT], intracutaneous test, and allergen specific immunoglobulin E levels [sIgE] to detect sensitization). Receiver operating characteristic curves were used for the analyses and the areas under the curve were calculated. RESULTS: For D. pteronyssinus and D. farinae, 86 and 70 complete data files, respectively, were available. For both tested HDMs, the results of the receiver operating characteristic curves showed a significant correlation for SPT and sIgE, with the results of the NPT (area under the curve, 0.742 to 0.763) but not for the intracutaneous test. In patients with a positive SPT (≥3 mm), an allergy was confirmed by the NPT in 69% of cases for D. pteronyssinus and 71% for D. farinae. A positive sIgE result (ImmunoCAP class of ≥2) was verified by the NPT in 69% of cases (D. pteronyssinus) and 70% (D. farinae). CONCLUSION: The predictability value for a positive NPT result is best for SPT and sIgE. Nevertheless, even if the results of both test systems are combined, the positive predictive value that was achieved was only 0.77 for D. pteronyssinus and 0.69 for D. farinae. Therefore, in patients eligible for immunotherapy for HDM, an NPT should be performed before the start of the therapy to verify a clinically relevant allergy. SN - 1945-8932 UR - https://www.unboundmedicine.com/medline/citation/26867532/Correlation_of_skin_test_results_and_specific_immunoglobulin_E_blood_levels_with_nasal_provocation_testing_for_house_dust_mite_allergies_ L2 - http://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4262?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -