Contact urticaria and respiratory symptoms induced by indirect contact with goat dander: a case report on vet's wife exposure.
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Solid phase enzyme immunoassay (EIA) and passive haemagglutination techniques were used to study the occurrence of IgG-type antibodies against feline and bovine epithelial extracts among RAST-positive patients, senior veterinary students, cat fanciers (representing exposed subjects) and healthy controls. In most groups both techniques exhibited equal sensitivity being positive in about half of the RAST-positive cases. The levels of both EIA-reactive IgG-class and IgA-class antibodies were increased in most of the sera (greater than mean + 2 s.d. of controls), while only a few sera showed increased IgM values.
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The occurrence of house dust mites was measured in the homes of 12 patients with the scaly skin disease, psoriasis. The median number of mites in the mattress dust and floor dust was 27 (range 10-153)/0.1 g and 56 (range 12-114)/0.1 g respectively, which is significantly higher than the background pollution of house dust mites in normal Danish homes. The results support the idea that the amount of mites in our homes not only depend on relative air humidity but also on the production of dandruff.
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The results of skin tests (ST) were compared with those of 2,055 provocation tests (PT) in 403 patients with asthma and/or allergic rhinitis. The overall agreement between ST and PT results was 77%. Various correlation figures were found for different allergens. In patients with pronounced allergy in the shock organ the prportion of positive ST was higher than in those with low-grade allergy. It is concluded that only strong ST reactions should be relied upon. In other cases additional diagnostic methods are reccommended. The diagnostic precision of ST is of the same order of sizes as that of the radioallergosorbent test.
Case histories alone and combined with the results of skin tests and/or the radioallergosorbent test (RAST) were compared with the results of provocation tests in 397 patients with asthma or allergic rhinitis. Case histories often turned out to be doubtful. The agreement between negative histories and negative provocation tests was 77% and that between positive histories and positive provocation tests 64%. When case histories were supported by concordant skin test or RAST results, the agreement with provocation tests increased to about 90%. When a scoring system for the combinations of different diagnostic methods was employed, a 100% agreement with provocation tests was obtained for cases with high scores. It is concluded that by using the case history in conjunction with RAST and/or skin test results, a reliable diagnosis can be achieved, eliminating the necessity of provocation tests.
An enzyme-linked immunosorbent assay (ELISA) employing allergen adsorbed onto the internal surface of a plastic tube, and alkaline phosphatase conjugated anti-IgE was used for the determination of specific IgE antibodies to various inhalant allergens in serum samples from 255 individuals with asthma and/or allergic rhinitis. A total of 541 analyses were carried out and the results were compared with those of provocation tests, skin tests and the RAST. It was found that negative ELISA values with high probability indicated nonallergy and very high ELISA values (class greater than or equal to 5) indicated allergy. However, the proportion of positive ELISA values which did not correspond to clinical allergy was high, as were the number of intermediate, inconclusive values (class 1-2). Although significant correlations between the ELISA values and provocation test, skin test or the RAST were obtained with some allergens, it was concluded that our version of the ELISA has not advantages over currently used methods for allergy diagnosis.
The sera from 25 patients with clinical type I allergy against dogs were investigated by means of immunoblotting, using extracts of dog hair/dander, skin, hair, saliva, salivary gland, serum and liver. 96% of the patients' sera showed IgE antibodies reactive with 19- and 23-kilodalton (kDa) proteins in the hair/dander extract. The 23-kDa IgE-binding protein was preferentially detected in the hair extract and saliva but not in skin, salivary gland, serum and liver extracts. The 19-kDa band was strongly expressed in skin, but not in hair, serum and liver. Inhibition experiments using the 23-kDa containing extract prepared from hair and the 19-kDa containing extract prepared from skin revealed that these two proteins are likely to be immunologically independent allergens.
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