Complex diagnosis of IgE mediated allergy by in vivo and in vitro methods (original) (raw)

Background: Skin prick testing (SPT) is an essential tool in the diagnosis of allergic disorders. The optimal number and type of allergens used in different settings remains undefined. We aim to describe SPT in our clinical practice and propose the appropriateness of reducing the number of pollen allergens to three. The aim is to improve cost-effectiveness and reducing time spent on allergen testing, particularly in the community setting. Methods: Consecutive patients who attended the private rooms of 2 immunologists and the allergy/immunology clinic in a tertiary referral hospital who required skin prick testing were evaluated from June 2006 to November 2006. Statistical analysis was undertaken with the use of Pearson`s Chi-square and Fisher`s Exact test to assess for significance. Multivariate analysis was also performed. Results: There were a total of 273 skin prick test sets performed. There was no significant difference between the rates of SPT positivity with common pollen allergens between the two clinics. A positive SPT to Perennial Ryegass (Lolium perenne), Timothy (Phleum patense) or Bermuda grass (Cynodon dactylon) had a sensitivity of 100% to Bent or Orchard grass (Dactylis glomerate), with sensitivities of 97%, 96.3% and 94.8% to English Plantain (Plantago lanceolata), Bahia grass (Paspalum notatum)and Dock/Sorrel (Rumex sp) respectively. Use of Perennial Ryegrass, Timothy or Bermuda grass also detected tree pollen sensitivity with sensitivities in Birch mix (Betula sp) of 92.6%, Acacia (96.4%), Casuarina (89.1%), Platanus sp (92.3%) and Privet(Ligustrum sp) (88.6%). Conclusion: The use of 3 common grass pollen allergens in SPTs (Lolium perenne, Phleum pratense and Cynodon dactylon) detected 90% of atopic individuals with sensitivity to many pollen types. This information may be useful in defining the most appropriate allergens to determine pollen hypersensitivity in community settings.