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Results for “Radioallergosorbent Test”

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PubMed2002

Rhinitis (allergic and nonallergic) in an atopic pediatric referral population in the grasslands of inland South Africa.

BACKGROUND: Allergic rhinitis is a common condition, which causes considerable morbidity. South African data are scarce. OBJECTIVE: We sought to describe allergic rhinitis in atopic children in inland South Africa. METHODS: An observational, descriptive study of rhinitis occurring in 771 new patients seen consecutively by a single observer at a referral pediatric allergy clinic (Universitas Hospital, Bloemfontein) over an 8 1/2-year period (August 1984 to March 1993) was carried out. A detailed questionnaire was used to record clinical data. Chest and sinus x-rays, skin prick testing, and radioallergosorbent test were performed, and serum immunoglobulin E levels were determined. Response to drug treatment regimens was recorded at subsequent followup visits. RESULTS: Significant rhinitis was reported in 78.1% of patients, and mild intermittent rhinitis was reported in 21.4%. Male to female ratio was 1.6:1. Median age at onset of rhinitis symptoms was 6 months (range 0 months to 12 years), with 30.1% experiencing symptoms from birth. Rhinitis was chronic in 61.3%, although 53.5% reported seasonal variation. More children with rhinitis were born in midsummer than during other seasons, although this did not reach statistical significance (P = 0.46). Breast-feeding had no protective effect, and parental smoking and household pets were not found to be risk factors. Family history was positive for allergic rhinitis in 88% of patients. Exposure to dust, weather changes, strong odors, pets, pollens, and tobacco smoke were the most common trigger factors. Sinus x-ray findings associated poorly with clinical findings. The most common allergens identified were grass pollen, tree pollen, and cat. Oral antihistamines provided good symptomatic relief in 62.9% of patients who used them. Intranasal corticosteroids provided good relief in 78.0% of those who used them, and ketotifen provided relief in 54.4% of those who used it. CONCLUSIONS: Rhinitis is a common manifestation of allergy in the population studied. Onset occurs early in childhood. A family history of allergy is a risk factor for the development of the condition, and grass pollen is the most common allergen involved. Special investigations are of limited value. Appropriate treatment is very effective.

Child↗

PubMed2001

Repeated latex aeroallergen challenges employing a hooded exposure chamber: safety and reproducibility.

BACKGROUND: Bronchial, nasal, and conjunctival challenges are useful for clarifying discordant clinical history (Hx) and skin and/or serologic tests and in assessing semiquantitative changes in biologic sensitivity over time. The objective of this study was to determine the safety and reproducibility of repeated latex-allergen challenges with a hooded exposure chamber (HEC). METHODS: The HEC system comprises a powered forced-air respirator with a fitted face shield and hood that uses glove-derived latex-allergen associated cornstarch particles (LAC) to expose simultaneously the conjunctiva, nose, and lungs. Serial control and incremental LAC challenges are conducted until an endpoint based on upper and/or lower respiratory tract symptoms and peak expiratory flow rates is reached. Six latex-allergic (Hx and puncture skin test [PST]- and 5/6 radioallergosorbent test [RAST]-positive) subjects were challenged on three separate occasions at least 2 weeks apart. Serial latex PST midpoints and serum anti-latex IgE by RAST were monitored at each visit and at a fourth follow-up visit. RESULTS: All subjects responded to LAC, but not to air or control cornstarch administered as controls. All responses were confined to mild symptoms of allergic rhinoconjunctivitis and/or asthma that either resolved spontaneously or were reversed with inhaled albuterol. No subject experienced a systemic or delayed reaction. There were no significant changes in the endpoint LAC doses over the three challenge visits (P>0.2). The mean coefficient of variation for log2 endpoints within-subjects was 17.3+/-17.2% (SD). The serum latex-specific IgE was not significantly boosted by the three challenges (P>0.2). The concentration of latex extract necessary to produce an 8-mm wheal by PST was not significantly changed during the study (P>0.1), indicating that latex sensitivity was not affected by the repeated LAC exposures. CONCLUSIONS: The results of this study indicate that repeated HEC latex-allergen challenges are both reproducible and safe, and do not increase latex sensitivity.

Administration, Inhalation↗

PubMed2002

Severe food-induced vasculitis in two children.

Food-induced vasculitis seems to be rare and is considered by some as controversial. The reported cases in the literature are few and mostly on adult patients. Described in this report are two children with severe vasculitis caused by specific foods. They were diagnosed at two separate allergy centers that have a special interest in food allergies. Case 1 was an 8-year-old girl with a 9-month history of cutaneous vasculitis with large joints involvement. Case 2 was a 23-month-old girl with an 8-month history of multiple hospitalizations for recurrent acute severe cutaneous and mucous membrane vasculitis with large joints involvement. In both patients, skin biopsy showed leucocytoclastic vasculitis. In neither of the patients could the symptoms be attributed to drug intake, infection, autoimmunity, or other systemic disease. Case 1 had a moderately elevated serum total immunoglobulin E (IgE) level and strongly positive skin test and radioallergosorbent test (RAST) to cow's milk and hen's egg, both of which were proven to be the cause by elimination-challenge tests. Case 2 had a slightly elevated serum total IgE level, but negative skin tests to foods, including chocolate that was suspected by the mother. Avoidance of chocolate resulted in remission, except following accidental ingestion of cocoa-containing products. These findings support the few previous reports on food-induced vasculitis, an entity that seems rare but may be more common than currently realized.

Child↗

PubMed2000

Clinical cross-reactivity among foods of the Rosaceae family.

BACKGROUND: Foods from the Rosaceae botanical family have been increasingly reported as causes of allergic reaction. Patients frequently have positive skin tests or radioallergosorbent test results for multiple members of this botanical family. OBJECTIVE: Our purpose was to investigate the clinical cross-reactivity assessed by double-blind, placebo-controlled food challenge (DBPCFC) of Rosaceae foods (apricot, almond, plum, strawberry, apple, peach, and pear). METHODS: Thirty-four consecutive adult patients complaining of adverse reactions to Rosaceae were included in the study. Skin prick tests and CAP System (FEIA) were performed with Rosaceae foods in all patients. Clinical reactivity to Rosaceae was systematically evaluated by open food challenges (OFCs), unless there was a convincing history of a recent severe anaphylaxis. Positive reactions on OFCs were subsequently evaluated by DBPCFCs. RESULTS: Twenty-six and 24 patients had positive skin prick tests and CAP FEIA with Rosaceae, respectively; from these 88% and 100% had positive tests with >/=2. No evidence of clinical reactivity was found in 66% percent of positive skin prick tests and 63% of positive specific IgE determinations to fruits. A total of 226 food challenges (including OFC and DBPCFC) were performed in the 28 patients with positive skin prick tests or CAP System FEIA. Of 182 initial OFCs carried out, 26 (14%) reactions were confirmed by DBPCFCs. Overall, 40 reactions were considered positive in 22 patients with positive skin tests or CAP FEIA. Thirty-eight reactions had been previously reported, the remaining two were detected by systematic challenges. Most reactions were caused by peach (22 patients), apple (6), and apricot (5). Ten patients (46%) were clinically allergic to peach and other Rosaceae. CONCLUSION: Positive skin test and CAP System FEIA should not be taken as the only guide for multi-species dietary restrictions. Nevertheless, the potential clinical allergy to other Rosaceae should not be neglected. If the reported reaction is confirmed, current tolerance to other Rosaceae should be precisely established unless there has been ingestion without symptoms after the reaction.

Adolescent↗

PubMed1993

Food allergy. Manifestations, evaluation, and management.

Allergic reactions to food are more common among infants and children but occur in adults as well. Foods that are most often implicated in allergic reactions are eggs, cow's milk, nuts, wheat, soy products, whitefish, and crustacea. Gastrointestinal, respiratory tract, and dermatologic symptoms, as well as systemic anaphylaxis, may develop. In addition to history taking and physical examination, the workup may include skin testing, the radioallergosorbent test, and double-blind oral food challenge. Avoidance of offending antigens is the most important aspect of treatment. If exposure occurs, antihistamines and epinephrine may be needed for treatment of an acute reaction.

Adult↗

PubMed2000

Intolerance to cereals is not specific for coeliac disease.

BACKGROUND: Abdominal complaints after ingestion of cereals are not uncommon. We assessed how reliable such a history is as a marker for the presence of overt coeliac disease, and whether we should also take into account latent coeliac disease and cereal allergy. METHODS: The study group comprised 93 consecutive adults from health centres spontaneously reporting abdominal symptoms after consumption of cereals. Small bowel mucosal morphology, CD3+, alphabeta+ and gammadelta+ intraepithelial lymphocytes (IELs), HLA DQ alleles and serum IgA-class endomysial (EmA), tissue transglutaminase (tTg) and gliadin (AGA) antibodies were determined. Skin prick and patch tests and serum radioallergosorbent tests for cereals were carried out. Thirty non-coeliac adults served as biopsy controls. RESULTS: Eight (9%) patients had coeliac disease and one mild partial villous atrophy. Altogether 17 had an increased density of gamma delta+ IELs without atrophy. However, only seven (8%) showed evidence of latent coeliac disease, i.e. both an increase in gammadelta+ IELs and the presence of coeliac disease-type HLA. One or more of the allergy tests for cereals was positive in 19; 9 adopted a gluten-free diet and abdominal symptoms were alleviated in all. In non-coeliac patients, serum EmA and tTg tests were negative in all, whereas AGA was seen in 40%. CONCLUSIONS: Intolerance to cereals is not a specific sign of overt or latent coeliac disease. All experimental dietary interventions before proper diagnosis of coeliac disease are therefore to be discouraged. Allergy to cereals, on the other hand, should be considered even in adults.

Adult↗

PubMed2000

Alternaria-associated asthma.

In addition to house dust mites, there is increasing evidence that mold allergens, especially Alternaria, are implicated in contributing to allergic reaction, rhinitis, and asthma indoors. Situations leading to the exacerbation of asthma in an employee were investigated and subsequent medical evaluations were performed. An industrial hygiene study was conducted and bioaerosol testing revealed several mold allergens were present. However, based on the medical evaluation and testing results (skin prick test and radioallergosorbent test [RAST]), it was concluded that Alternaria was inducing the respiratory reaction. Alternaria was present in the drip pan of the air conditioner unit and remedial actions were taken to remove the mold. Post-remedial bioaerosol sampling results revealed Alternaria was no longer present in the air and the employee returned to the office without recurrence of symptoms. Practically, several factors should be considered prior to concluding an association between exposure and illness. First, the employee's symptoms and signs should be consistent with a medical diagnosis. Second, there should be either in vitro or in vivo evidence of exposure. Third, environmental assessment should reveal evidence of plausible biological exposure. Fourth, there should be substantial improvement or even resolution of the illness after appropriate remediation of the health hazard. This case study illustrates the importance of teamwork by industrial hygienists and occupational health physicians in treatment and prevention of occupational and environmental diseases.

Adult↗

PubMed2002

Patients with negative skin tests.

PURPOSE OF REVIEW: The aim of this article is to present and discuss the clinical problem of systemic anaphylaxis to Hymenoptera venoms in patients without detectable immunoglobulin E, as it appears in recent literature. Reported at variable frequency in large series of patients undergoing evaluation, systemic anaphylaxis was previously considered to reflect lost sensitization or to involve non-immunoglobulin E mediated mechanisms. Sporadic case-reports drew attention to the fact that severe or even fatal reactions may occur in patients with negative skin tests. RECENT FINDINGS: A breakthrough article by Golden et al., who performed deliberate stings on skin test negative venom anaphylaxis patients, demonstrated that clinical sensitivity was still present in a subset of these subjects and pointed out to the limitations of present diagnostic methods or reagents. New immunobiochemical methods and highly specific recombinant allergens--when all clinically relevant Hymenoptera venom allergens have been identified, cloned, sequenced and expressed in the proper system--are anticipated to increase the diagnostic yield. Non-specific mechanisms causing anaphylactoid reactions will probably explain some enigmatic, skin test negative radioallergosorbent test negative cases in the future. Occult mastocytosis, predisposing patients to anaphylactoid reactions, has been reported with increasing frequency among skin test negative patients. Lastly, other causes mimicking venom anaphylaxis may on rare occasions contribute to the problem. SUMMARY: With the present understanding of venom allergy, the practising clinician is not infrequently faced with the dilemma of the skin test negative patient. Once other identifiable causes have been carefully ruled out, referral to a specialized center for deliberate sting-challenges appears in selected cases to be a medically appropriate and ethically justified management approach.

Allergens↗

PubMed2004

Mastocytosis and Hymenoptera allergy.

PURPOSE OF REVIEW: Mastocytosis is a rare disease with associations with anaphylactic reactions to Hymenoptera stings. The purpose of this review is to examine these associations with regard to prevalence, diagnosis, treatment and prognosis in the insect-venom-allergic population. RECENT FINDINGS: Systemic mastocytosis is overrepresented in the Hymenoptera-allergic population and is associated with an increased risk of more-severe reactions following field stings or sting challenges, lack of sensitization to venoms by skin test or radioallergosorbent test, increased side effects to venom immunotherapy, reduced efficacy of venom immunotherapy and treatment failures. Serum tryptase determinations are a simple and reliable screening procedure for systemic mastocytosis. Patients with elevated values should be referred to specialized centers for confirmatory diagnosis including bone marrow histology. SUMMARY: The diagnosis of systemic mastocytosis should be considered in Hymenoptera-allergic patients showing any of the management problems associated with this disease. Patients with mastocytosis and Hymenoptera allergy require special attention, mainly because of reduced safety and efficacy of venom immunotherapy. Whether or not venom immunotherapy is given, such patients should continue to carry an Epipen indefinitely.

Animals↗

PubMed1983

Allergenic properties of a feed protein of microfungal origin.

We studied thirty-five process and laboratory workers occupationally exposed to Paecilomyces varioti protein. The protein, used as an animal feed, is prepared industrially by fermentation in pulp waste liquor. Skin tests and radioallergosorbent tests (RAST) to detect specific IgE antibodies showed positive results to Paecilomyces antigen among the workers and among the atopic control persons not occupationally exposed to Paecilomyces protein. Also IgG antibodies to Paecilomyces protein could be detected in workers and in controls in similar amounts in both groups. In no worker could clinical symptoms due to Paecilomyces protein allergy be found. We conclude that positive skin tests and RASTs indicate that immediate hypersensitivity to Paecilomyces antigens occurs. Clinical allergy probably has been prevented by the closed manufacturing process, which keeps occupational exposure at a low level.

Adult↗

PubMed1994

Immediate hypersensitivity to bakery, brewery and wine products in yeast-sensitive atopic dermatitis patients.

Ultrafiltered (> 1000 Da) samples of beer, aged red wine, young white wine, sparkling wine and extracts of fresh wheat bread and dried rye bread were analysed by skin-prick test (SPT), radioallergosorbent test (RAST) inhibition, sodium dodecylsulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting to find out if they contain Saccharomyces cerevisiae (S. cerevisiae, baker's yeast) allergens. Serum pool consisting of S. cerevisiae positive sera was used in the assays. The results were compared with freeze-dried reference S. cerevisiae and cereal antigens. The beer, bread, red wine and sparkling wine extracts elicited immediate reactions. However, no evident correlation with suspected symptoms was observed. White wine extract caused reactions in four out of six atopic dermatitis (AD) patients with symptoms, and in five out of seven symptom-free AD patients and in two of the 24 controls. In SDS-PAGE, protein bands were found in wheat and rye bread extracts and beer. In IgE immunoblotting, however, no staining was seen with the S. cerevisiae positive sera suggesting that they were of cereal origin. In white wine and champagne extracts a non-specific staining was seen in the region 20 kDa representing, e.g. lectin-like activity. No baker's yeast antigen could be detected in brewery and bakery products with IgE-immunoblotting even in the excessively concentrated extracts. The IgE mediated allergy to baker's yeast alone should thus not lead to denial of bakery, brewery and wine products.

Adolescent↗

PubMed1996

Increased levels of hyaluronan and albumin after intestinal challenge in adult patients with cow's milk intolerance.

BACKGROUND: The mechanisms for adverse reactions to foods in the gastrointestinal tract are poorly understood. Presently, only limited possibilities are available for identification of adverse immunological reactions to different foods. OBJECTIVE: The intestinal inflammatory reactions in adult patients with a history of milk-related gastrointestinal symptoms were studied after intestinal challenges by a jejunal perfusion technique and compared with the reactions in a control group. METHODS: Five skin-prick test and radioallergosorbent test negative and lactose tolerant patients with a history of milk-related gastrointestinal symptoms, verified by double-blind placebo-controlled challenge, and eight healthy controls were investigated. Perfusions were performed allowing analyses of a well-defined 'closed' jejunal segment. Milk perfusions were performed in patients and controls after an overnight fast. Ten millilitres of milk were administered to the segment at 3 mL/min. The jejunal fluid levels of hyaluronan (hyaluronic acid) and albumin were measured. RESULTS: In the five patients the milk challenges induced as a mean fivefold increased levels of hyaluronan compared with prestimulation values, whereas no such increases were seen in the control subjects. Albumin, as a marker of plasma leakage, was also increased in the patients but not in the control subjects. CONCLUSION: The underlying mechanisms for locally increased levels of hyaluronan and also albumin in the intestinal lumen may be secretion of lymph rich in hyaluronan and reflect the mucosal oedema. This capacity of the intestinal mucosa to react with lymph leakage towards a locally infused allergen may be a possible way to delineate gastrointestinal reactions in food-related disorders.

Adult↗

PubMed2005

Atopy patch testing with aeroallergens in patients with atopic dermatitis and controls in Singapore.

The role of allergy in atopic dermatitis is controversial. The atopy patch test (APT) has been used to investigate the association between atopic dermatitis and aeroallergen allergy. To determine the proportion of patients with atopic dermatitis with positive patch tests to common local aeroallergens and to compare this to controls with and without respiratory atopy, we performed APT, skin-prick tests (SPT) and IgE radioallergosorbent tests (RAST) on 73 patients with atopic dermatitis and on 38 nonatopic controls (13 with and 25 without respiratory atopy). The allergens used were house dust mite, cat dander, Bermuda grass and German cockroach. Only the APT for house dust mite showed a significant difference between the two groups. APT for house dust mite correlated with the RAST test, while APT for cat fur correlated with the SPT. The APT may be useful to evaluate aeroallergens in atopic dermatitis, but further work is needed to make it more reliable.

Adolescent↗

PubMed1998

Diagnostic tests in children with atopic dermatitis and food allergy.

BACKGROUND: Skin testing is a common diagnostic procedure in food allergy. The skin prick test is the test of first choice for investigating the immediate IgE-mediated reaction. The skin application food test (SAFT) has been developed on the basis of the mechanism of the contact urticaria syndrome (CUS). METHODS: We studied the relevance of the SAFT in children younger than 4 years with atopic dermatitis and (suspected) food allergy as compared with the prick-prick test, the radioallergosorbent test (RAST), and the oral challenge. In the skin tests, we used fresh food, in the same state as it was consumed. RESULTS: There was a good agreement between the SAFT and the prick-prick test. A moderate agreement was observed between the SAFT and the serologic test (RAST). Significantly more positive results in the RAST were observed than in the SAFT. There was very good agreement between the SAFT and the oral challenge (kappa = 0.86). CONCLUSIONS: The SAFT is a reliable and child-friendly skin test for evaluating (suspected) food allergy in children younger than 4 years with atopic dermatitis. The very good correlation with the oral challenge indicates that one may probably consider the SAFT a "skin provocation" in children younger than 4 years.

Allergens↗

PubMedDate not supplied

Adverse reactions to food and clinical expressions of food allergy.

Adverse reactions to foods are frequent in everyday life. They are divided into toxic and immunologic food reactions. The awareness of toxic food reactions among adverse reactions to food is essential for correct diagnosis. Enzymatic food intolerance, adverse reactions to food or food additives, pharmacologic food intolerance, psychosomatic factors, food allergy with classic symptoms (anaphylaxis, urticaria-angioedema), atopic dermatitis, contact dermatitis (protein), upper and lower respiratory symptoms like rhinitis or asthma, and gastrointestinal disorders (oral allergy syndrome, colic, nausea, vomiting, diarrhea, abdominal pain) are discussed. Target organs throughout the body-ear, eye, pharynx, skin, lung, joints, and muscles-can be involved. The gold standard in diagnosis is a double-blind, placebo-controlled food challenge test. The diagnostic tools available for most food-related disorders are the skin-prick test and radioallergosorbent test. The treatment of food-induced urticaria consists of elimination of the offending food or substance from the diet, use of antihistamines, and immunotherapy.

Food↗

PubMed1992

A 10 year follow up of 180 adults with bronchial asthma: factors important for the decline in lung function.

BACKGROUND: Little is known about the factors that determine outcome in asthma. The purpose of this study was to describe the relation of various factors of potential importance to the rate of decline in lung function in adults with intrinsic and extrinsic asthma. METHODS: Of 180 asthmatic patients, 143 (79%) participated in a 10 year follow up examination. At the time of enrollment all patients underwent certain tests for asthma (case history, total IgE, skinprick tests, the radioallergosorbent test (RAST), histamine release from basophil leucocytes, and specific bronchial provocations). On the basis of these tests 94 patients had intrinsic asthma and 49 extrinsic asthma. RESULTS: Patients with intrinsic asthma had an annual decline in FEV1 of 50 ml, whereas those with extrinsic asthma had a decline of 22.5 ml; the rate of decline of lung function increased with increasing age in both groups. An inverse relation between initial FEV1 and decline in FEV1 (the "horse racing effect") was found for the patients with extrinsic asthma but not for the patients with intrinsic asthma. There was no relation between rate of decline in lung function and number of cigarettes smoked. A high degree of airway variability--that is, reversibility in FEV1--at the time of enrollment was found to be associated with a steeper decline in lung function in patients with intrinsic asthma, whereas increasing degrees of obstruction (decreasing FEV1/VC ratio at enrollment) and need for treatment with corticosteroids were associated with a more pronounced decline in FEV1 in patients with extrinsic asthma. CONCLUSIONS: The rate of decline in lung function is greater in patients with intrinsic asthma than in patients with extrinsic asthma; the prognosis for intrinsic and extrinsic asthma is to some extent influenced by different factors, which suggests that the pathogenetic mechanisms underlying intrinsic and extrinsic asthma may differ.

Adult↗

PubMed1994

Diagnosis of allergic fungal sinusitis.

Allergic fungal sinusitis is a noninvasive disease first recognized approximately one decade ago. It accounts for approximately 6% to 8% of all chronic sinusitis requiring surgical intervention and has become a subject of increasing interest to otolaryngologists and related specialists. Although certain signs and symptoms, as well as radiographic, intraoperative, and pathologic findings, may cause the physician to suspect allergic fungal sinusitis, no standards have been defined for establishing the diagnosis. It is extremely important to recognize allergic fungal sinusitis and differentiate it from chronic bacterial sinusitis and other forms of fungal sinusitis because the treatments and prognoses for these disorders vary significantly. To delineate a set of diagnostic criteria, we prospectively evaluated our most recent 15 patients with allergic fungal sinusitis. An allergy evaluation confirmed atopy through a strong history of inhalant mold allergies, an elevated total immunoglobulin E level, or a positive result of a skin test or radioallergosorbent test to fungal antigens in 100% of patients. All 15 patients had nasal polyposis, and 8 of 15 had asthma. There was a unilateral predominance in 13 of 15 cases. A characteristic computerized tomography finding of serpiginous areas of high attenuation in affected sinuses was seen in all patients, and 12 of 15 patients had some degree of radiographic bone erosion. Pathologic examination uniformly revealed eosinophilic mucus without fungal invasion into soft tissue; Charcot-Leyden crystals and peripheral eosinophilia were each observed in 6 of 15 patients. Every patient had fungus identified on fungal smear, although only 11 of 15 fungal cultures were positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2001

Preventing and managing drug-induced anaphylaxis.

Drug-induced anaphylaxis and anaphylactoid reactions have increased in frequency with more widespread use of pharmaceutical agents. Anaphylaxis is a systemic, severe immediate hypersensitivity reaction caused by immunoglobulin (Ig) E-mediated immunological release of mediators of mast cells and basophils. An anaphylactoid reaction is an event similar to anaphylaxis but is not mediated by IgE. The incidence of anaphylactic or anaphylactoid reactions differs amongst classes of medications. Antibacterials are the most usual offenders, and penicillins are the most studied. Other compounds commonly causing reactions include non-steroidal anti-inflammatory drugs, anaesthetics, muscle relaxants, latex and radiocontrast media. Prevention, if possible, is the purpose of detailed patient history taking and physical examination. Simple strategies can be employed to decrease the risk of anaphylaxis. These include consideration of the route of drug administration, identification of patients with known causes of anaphylaxis, and the knowledge that certain medications cross react and are contraindicated in those with known history of anaphylaxis. Tests are available, and include IgE-specific skin tests and radioallergosorbent tests. Penicillins are the only compounds whose antigenic determinants are well documented, it is therefore difficult to determine the negative predictive value of other compounds tested. Oral challenge remains an alternative, though entails risk. Desensitisation procedures, as well as gradual dose escalation protocols, are available and can be implemented based on patient history and diagnostic testing. The management of anaphylaxis is based on control of the airway, breathing and circulation. Treatment consists of epinephrine (adrenaline) and supportive measures. Rapid diagnosis and intervention are important in these life-threatening reactions. After stabilisation, all individuals with a documented history of anaphylaxis require a Medic-Alert bracelet or necklace, and an identification card for their wallet or purse.

Adverse Drug Reaction Reporting Systems↗