Systemic Reactions to Percutaneous (P) and Intradermal (ID) Skin Tests (ST)
2007; Elsevier BV; Volume: 119; Issue: 1 Linguagem: Inglês
10.1016/j.jaci.2006.11.248
ISSN1097-6825
AutoresThomas Chacko, Mark C. Glaum, Dennis K. Ledford, Roger W. Fox, Richard F. Lockey,
Tópico(s)Animal testing and alternatives
ResumoRATIONALE: The purpose of this study is to determine over 6 months, 2/06-7/06, the rate of systemic reactions (SR) to both P and ID ST, the symptoms reported, and the response to immediate treatment with epinephrine IM. METHODS: A retrospective review over a 6 month period was conducted to evaluate the reactions to P and ID ST to 20 to 50 allergens (trees, grasses, weeds, animals, molds, food, medications, and Hymenoptera) in 792 subjects. A standard form was used to record symptoms, signs, and treatment. No vasovagal reactions were included. RESULTS: 32 patients (4%) had SRs, 26 (81%)female and 6 (19%) male. The average age of the patients with SRs was 41.4 years (range 14-70, median 36.5 years). 10/32 (31%) had asthma. Symptoms reported: pruritic eyes, nose, and/or pharynx (31%), worsening cough (22%), rhinorrhea (19%), chest tightness and/or shortness of breath (19%), generalized pruritus(16%), worsening nasal congestion (16%), sneezing (13%), sensation of difficulty swallowing (9%), urticaria (3%), and wheeze (3%). No severe asthma, shock, hypotension, unconsiousness, or late phase responses occurred. Treatment: 32 (100%) patients received epinephrine (average dose 0.2 cc, 1:1000 IM), 29 (91%) prednisone, 6 (19%) prednisone to take 6 to 8 hours after reaction, 30 (92%) oral antihistamine (H1), and 5 (16%) nebulized beta agonist. CONCLUSION: SRs occur in 4% of patients skin tested, and respond to early intervention with epinephrine, prednisone and/or H1 antihistamines. No late phase reactions occurred.
Referência(s)