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Abstract

OBJECTIVE: Examine the efficacy of epicutaneous and intradermal testing in predicting response to nasal provocation with timothy antigen.

STUDY DESIGN AND SETTING: Prospective study. Subjects were tested with Multi-Test II (MT). Subjects with negative wheals were tested with a 1:500 intradermal injection of timothy. They had baseline assessment of nasal cross-sectional area (CSA) using acoustic rhinometry and underwent nasal provocation with increasing timothy concentrations. CSA was assessed and nasal visual analog scale (VAS) completed with each concentration.

RESULTS: Sensitivity and specificity of MT in predicting nasal response to provocation were 87% and 86%. Intradermal testing increased sensitivity to 93%. Hierarchical linear modeling (HLM) demonstrated that subjects positive to skin testing had significant reductions in CSA and worsening VAS scores with increasing concentrations of nasally delivered antigen.

CONCLUSION AND SIGNIFICANCE: Epicutaneous testing with the Multi-Test II offers 87% sensitivity and 86% specificity in assessing timothy grass reactivity.

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References

Keenan

. History of skin testing and evolution of skin endpoint titration. In: Mabry

, editor. Skin endpoint titration. New York: Thieme; 1992. p. 12–6

Phillips

. Relief of hayfever by intradermal injections of pollen extract. JAMA 1926;86:182–4

Rinkel

. The management of clinical allergy. Part II, etiologic factors and skin titration. Arch Otolaryngol 1963;77:42–75

Krouse

. Efficacy of immunotherapy based on skin end-point titration. Otolaryngol Head Neck Surg 2000;123:183–7

Nelson

Lahr

Buchmeier

McCormick

. Evaluation of devices for skin prick testing. J Allergy Clin Immunol 1998;101:153–6

Levine

Mabry

. Comparison of Multi-Test device skin testing and modified RAST results. Otolaryngol Head Neck Surg 1998;118:797–9

Murphree

Kniker

. Correlation of immediate skin test responses to antigens introduced by multi-test and intracutaneous routes. Ann Allergy 1979;43:279–85

Gungor

Houser

Aquino

. Comparing skin endpoint titration to other forms of allergy testing. ENT J 2004;83:54–60

Hurst

Gordon

Krouse

. The importance of glycerin-containing controls in the interpretation of allergy skin tests. Otolaryngol Head Neck Surg 2002;127:177–81

10.

Krouse

Shah

Kerswill

. Skin testing in predicting response to nasal provocation with Alternaria. Laryngoscope, in press

11.

Coutras

. Can the Multi-Test II predict the endpoint of the intradermal dilution test? Paper presented at the Annual Meeting of the American Academy of Otolaryngic Allergy, September 19, 2003.

Sensitivity and Specificity of Prick and Intradermal Testing in Predicting Response to Nasal Provocation with Timothy Grass Antigen

Abstract

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References