Alerji Testlerinde Lanset, Çok Başlı Aplikatör ve Spesifik İmmunglobilin E’nin Tanısal Etkinliğinin Karşılaştırılması
Abstract
Amaç: Alerjik rinit ve alerjik astım, çocuklarda sık görülen solunum hastalıklarıdır. Bu hastalıkların tanısında, deri prik testleri (DPT) ve alerjen spesifik immunglobulin E (SpIgE) ölçümleri önemli bir rol oynamaktadır. Son yıllarda hızlı tanı kitlerinin kullanımı artmıştır. Bu çalışmanın amacı çok başlı aplikatör ve alerjen SpIgE’lerin tanısal performanslarını altın standart kabul edilen lanset DPT göre etkinlikleri araştırıldı.
Gereç ve Yöntem: Çok başlı aplikatör, lanset ile aynı alerjen solüsyonları kullanılarak aynı hastalara deri prik testleri yapıldı. Ayrıca, her hastadan alerjen SpIgE düzeyleri ölçüldü. Lanset ile yapılan DPT’lere göre çok başlı aplikatör ve alerjen SpIgE’lerin tanısal performansları istatistiksel olarak incelendi.
Bulgular: Toplamda alerjen SpIgE’leri de alınan 105 hasta üzerinde 2100 DPT yapıldı. Hastalarda sıklık sırasına göre ev tozu akarı, polenler ve küf alerjen duyarlılığı saptandı. Çok başlı aplikatör ile yapılan DPT %73.3, lanset ile yapılan DPT %82.9 ve SpIgE ile yapılan test %81 oranında duyarlanma tespit edildi. Çok başlı aplikatörün tanısal duyarlılık değeri %0-52 arasında ve lanset ile korelasyonları zayıf bulundu.
Sonuç: Hızlı sonuç alma amaçlı testler, alerjen duyarlılığını tespitte yeterince etkin olmamıştır. Lanset ile yapılan DPT ve SpIgE ölçümleri gibi doğru ve güvenilir tanı yöntemlerinin kullanılması önemlidir. Bu çalışma, alerjen duyarlılığı tespitinde alerjen solüsyonları da kullanılarak yapılan farklı DPT yöntemlerinin değerlendirildiği ilk çalışma olma özelliği taşımaktadır ve alerjik hastalıkların tanı ve tedavisinde doğru yönlendirmeler yapmak adına önemli bilgiler sunmaktadır.
Thanks
Çalışmanın yapılması sırasındaki desteklerinden dolayı Doç.Dr.Çiğdem Aydoğmuş’a, Prof.Dr.M.Halil Çeliksoy’a, Doç.Dr.Pınar Gökmirza Özdemir’e, Uz.Dr Işılay Turan’a, Uz.Dr.Selami Ulaş’a ve hemşirelerimize teşekkür ediyorum.
References
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Comparison of Diagnostic Efficacy of Lancet, Multi-Head Applicator, and Specific Immunoglobulin E in Allergy Testing
Abstract
Objective: Allergic rhinitis and allergic asthma are common respiratory diseases in children. Skin prick tests (SPT) and allergen-specific immunoglobulin E (SpIgE) measurements play a crucial role in their diagnosis. In recent years, the use of rapid diagnostic kits has increased. This study aimed to investigate the diagnostic performance of multiheaded applicator and allergen SpIgE compared to the gold standard lanset.
Materials and Methods: Skin prick tests were conducted on the same patients using both a multi-headed applicator and lancet with the same allergen solutions. Additionally, allergen SpIgE levels were measured for each patient. The diagnostic performances of multi-headed applicator and allergen SpIgE were statistically compared to those of lancet.
Results: A total of 2100 SPTs were performed on 105 patients, from whom allergen SpIgE levels were also obtained. Allergen sensitivities were detected in order of prevalence as house dust mites, pollens, and molds. Sensitization rates were found to be 73.3% for multi-headed applicators, 82.9% for lanset, and 81% for SpIgE. The diagnostic sensitivity of the multiheaded applicator ranged from 0% to 52%, and its correlations with lanset were weak.
Conclusion: Rapid-result tests aimed at allergen sensitivity assessment showed limited effectiveness. The use of accurate and reliable diagnostic methods such as lancet-based SPT and SpIgE measurements is crucial. This study holds the distinction of being the first to evaluate different SPT methods using allergen solutions, providing important insights for accurate diagnosis and treatment of allergic diseases.
References
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- Scala E, Villalta D, Meneguzzi G, Brusca I, Cecchi L. Comparison of the Performance of Skin Prick and ISAC Tests in the Diagnosis of Allergy. Eur Ann Allergy Clin Immunol [Internet]. 2020 Nov;52(06):258. Available from: http://www.eurannallergyimm. com/cont/journals-articles/872/volume-comparison-performance-skin-prick-isac.asp google scholar
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- Kahveci M, Karabulut E, Soyer O, Sahiner UM, Buyuktiryaki B, Sekerel BE. Fine-tuning the use of a skin prick test device. World Allergy Organ J [Internet]. 2020 May 1 [cited 2022 Nov 23];13(5):100122. Available from: https://linkinghub.elsevier.com/ retrieve/pii/S1939455120300259 google scholar
- Heinzerling L, Mari A, Bergmann K, Bresciani M, Burbach G, Darsow U, et al. The skin prick test - European standards. Clin Transl Allergy [Internet]. 2013 Jan;3(1):3. Available from: https://onlinelibrary. wiley.com/doi/10.1186/2045-7022-3-3 google scholar
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- Masse MS, Granger Vallee A, Chiriac A, Dhivert-Donnadieu H, Bousquet-Rouanet L, Bousquet PJ, et al. Comparison of five techniques of skin prick tests used routinely in Europe. Allergy [Internet]. 2011 Nov 1 [cited 2023 Jul 27];66(11):1415-9. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1398-9995.2011.02679.x google scholar
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- Tversky JR, Chelladurai Y, McGready J, Hamilton RG. Performance and Pain Tolerability of Current Diagnostic Allergy Skin Prick Test Devices. J Allergy Clin Immunol Pract [Internet]. 2015 Nov [cited 2023 Jul 29];3(6):888-93. Available from: http://dx.doi. org/10.1016/j.jaip.2015.07.022 google scholar
- Werther RL, Choo S, Lee KJ, Poole D, Allen KJ, Tang MLK. Variability in skin prick test results performed by multiple operators depends on the device used. World Allergy Organ J [Internet]. 2012 Jan 1 [cited 2023 May 20];5(12):200-4. Available from: http://www. worldallergyorganizationjournal.org/article/S1939455119304016/ fulltext google scholar
- Morales-Palacios M de la P, Nunez-Cordoba JM, Tejero E, Matellanes Ö, Quan PL, Carvallo Â, et al. Reliability of a novel electro-medical device for wheal size measurement in allergy skin testing: An exploratory clinical trial. Allergy [Internet]. 2023 Jan 1 [cited 2023 Aug 10];78(1):299. Available from: /pmc/articles/ PMC10087902/ google scholar
- Gorris S, Uyttebroek S, Backaert W, Jorissen M, Schrijvers R, Thompson MJ, et al. Reduced intra-subject variability of an automated skin prick test device compared to a manual test. Allergy Eur J Allergy Clin Immunol. 2023;78(5):1366-8. google scholar
- Chiaranairungroj M, Chatchatee P, Srituravanich W. The effect of applied force and device design on skin prick test performance. Ann Allergy, Asthma Immunol [Internet]. 2023;130(3):312-6. Available from: https://doi.org/10.1016/j.anai.2022.11.014 google scholar
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 24, 2023 |
| Published in Issue | Year 2023 Volume: 23 Issue: 3 |
