A comparison of skin prick tests, intradermal skin tests, and specific IgE in the diagnosis of mouse allergy

Hemant P. Sharma, Robert A Wood, Andrea R. Bravo, Elizabeth C. Matsui

Research output: Contribution to journalArticle

Abstract

Background: Mouse sensitization is assessed by using skin testing and serum levels of mouse allergen-specific IgE (m-IgE). However, it is unknown whether a positive skin test response or m-IgE result accurately identifies those with clinically relevant mouse sensitization. Objective: We sought to compare skin testing and m-IgE measurement in the diagnosis of mouse allergy. Methods: Sixty-nine mouse laboratory workers underwent skin prick tests (SPTs), intradermal tests (IDTs), and serum IgE measurements to mouse allergen, followed by nasal challenge to increasing concentrations of mouse allergen. Challenge response was assessed by nasal symptom score. Results: Thirty-eight women and 31 men with a mean age of 30 years were studied. Forty-nine workers reported mouse-related symptoms, of whom 10 had positive m-IgE results and 12 had positive SPT responses. Fifteen had negative SPT responses but positive IDT responses. Positive nasal challenges were observed in 70% of workers with positive m-IgE results, 83% of workers with positive SPT responses, 33% of workers with negative SPT responses/positive IDT responses, and 0% of workers with negative IDT responses. SPTs performed best, having the highest positive and negative predictive values. Among participants with a positive challenge result, those with a positive SPT response or m-IgE result had a significantly lower challenge threshold than those with a positive IDT response (P = .01). Workers with a positive challenge result were more likely to have an increase in nasal eosinophilia after the challenge compared with those with a negative challenge result (P = .03). Conclusions: SPTs perform best in discriminating patients with and without mouse allergy. Mouse-specific IgE and IDTs appear to be less useful than SPTs in the diagnosis of mouse allergy.

Original languageEnglish (US)
Pages (from-to)933-939
Number of pages7
JournalThe Journal of Allergy and Clinical Immunology
Volume121
Issue number4
DOIs
StatePublished - Apr 2008

Fingerprint

Intradermal Tests
Skin Tests
Immunoglobulin E
Hypersensitivity
Allergens
Nose
Skin

Keywords

  • diagnostic testing
  • Mouse allergen
  • nasal challenge
  • skin test

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

A comparison of skin prick tests, intradermal skin tests, and specific IgE in the diagnosis of mouse allergy. / Sharma, Hemant P.; Wood, Robert A; Bravo, Andrea R.; Matsui, Elizabeth C.

In: The Journal of Allergy and Clinical Immunology, Vol. 121, No. 4, 04.2008, p. 933-939.

Research output: Contribution to journalArticle

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abstract = "Background: Mouse sensitization is assessed by using skin testing and serum levels of mouse allergen-specific IgE (m-IgE). However, it is unknown whether a positive skin test response or m-IgE result accurately identifies those with clinically relevant mouse sensitization. Objective: We sought to compare skin testing and m-IgE measurement in the diagnosis of mouse allergy. Methods: Sixty-nine mouse laboratory workers underwent skin prick tests (SPTs), intradermal tests (IDTs), and serum IgE measurements to mouse allergen, followed by nasal challenge to increasing concentrations of mouse allergen. Challenge response was assessed by nasal symptom score. Results: Thirty-eight women and 31 men with a mean age of 30 years were studied. Forty-nine workers reported mouse-related symptoms, of whom 10 had positive m-IgE results and 12 had positive SPT responses. Fifteen had negative SPT responses but positive IDT responses. Positive nasal challenges were observed in 70{\%} of workers with positive m-IgE results, 83{\%} of workers with positive SPT responses, 33{\%} of workers with negative SPT responses/positive IDT responses, and 0{\%} of workers with negative IDT responses. SPTs performed best, having the highest positive and negative predictive values. Among participants with a positive challenge result, those with a positive SPT response or m-IgE result had a significantly lower challenge threshold than those with a positive IDT response (P = .01). Workers with a positive challenge result were more likely to have an increase in nasal eosinophilia after the challenge compared with those with a negative challenge result (P = .03). Conclusions: SPTs perform best in discriminating patients with and without mouse allergy. Mouse-specific IgE and IDTs appear to be less useful than SPTs in the diagnosis of mouse allergy.",
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