Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion

Background: We evaluated the value of positive intradermal dilution testing (IDT) after negative skin prick tests (SPT) by retrospectively determining allergy immunotherapy (AIT) outcomes. Methods: This private practice, cohort study compared the relative value of SPT vs. IDT in 371 adults and child...

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Autores principales:	David S. Hurst, Alan B. McDaniel
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	allergic rhinitis allergens allergy immunotherapy asthma otitis media sinusitis Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/c88b3aa75eec40a3bcfba00273361e7f
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spelling	oai:doaj.org-article:c88b3aa75eec40a3bcfba00273361e7f2021-11-25T17:13:03ZClinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion10.3390/cells101132242073-4409https://doaj.org/article/c88b3aa75eec40a3bcfba00273361e7f2021-11-01T00:00:00Zhttps://www.mdpi.com/2073-4409/10/11/3224https://doaj.org/toc/2073-4409Background: We evaluated the value of positive intradermal dilution testing (IDT) after negative skin prick tests (SPT) by retrospectively determining allergy immunotherapy (AIT) outcomes. Methods: This private practice, cohort study compared the relative value of SPT vs. IDT in 371 adults and children with suspected manifestations of allergy: chronic allergic rhinitis (AR), asthma and/or chronic otitis media with effusion (OME). The primary outcome measure was symptom resolution following immunotherapy, as determined by symptom severity questionnaires completed by patients before and after AIT. Results: Positive IDT identified 193 (52%) patients who would not otherwise have been diagnosed. IDT detected 3.7-fold more allergens per patient than SPT (8.56 vs. 2.3; <i>p</i> < 0.01). Patients positive only on IDT responded to AIT equally well as those identifiable by SPT, independent of allergen sensitivity (67% by SPT vs. 62% by IDT; <i>p</i> = 0.69, not significantly different). Conclusion: Intradermal titration can identify patients who will benefit from allergy immunotherapy more accurately than SPT. Outcomes analysis in 371 patients shows that IDT doubled their chance of successful treatment with no greater risk of therapeutic failure. Positive IDT, following negative SPT, is clinically relevant and offers superior sensitivity over SPT for detecting allergens clinically relevant to diagnosis of AIT-responsive atopic disease.David S. HurstAlan B. McDanielMDPI AGarticleallergic rhinitisallergensallergy immunotherapyasthmaotitis mediasinusitisBiology (General)QH301-705.5ENCells, Vol 10, Iss 3224, p 3224 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	allergic rhinitis allergens allergy immunotherapy asthma otitis media sinusitis Biology (General) QH301-705.5
spellingShingle	allergic rhinitis allergens allergy immunotherapy asthma otitis media sinusitis Biology (General) QH301-705.5 David S. Hurst Alan B. McDaniel Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion
description	Background: We evaluated the value of positive intradermal dilution testing (IDT) after negative skin prick tests (SPT) by retrospectively determining allergy immunotherapy (AIT) outcomes. Methods: This private practice, cohort study compared the relative value of SPT vs. IDT in 371 adults and children with suspected manifestations of allergy: chronic allergic rhinitis (AR), asthma and/or chronic otitis media with effusion (OME). The primary outcome measure was symptom resolution following immunotherapy, as determined by symptom severity questionnaires completed by patients before and after AIT. Results: Positive IDT identified 193 (52%) patients who would not otherwise have been diagnosed. IDT detected 3.7-fold more allergens per patient than SPT (8.56 vs. 2.3; <i>p</i> < 0.01). Patients positive only on IDT responded to AIT equally well as those identifiable by SPT, independent of allergen sensitivity (67% by SPT vs. 62% by IDT; <i>p</i> = 0.69, not significantly different). Conclusion: Intradermal titration can identify patients who will benefit from allergy immunotherapy more accurately than SPT. Outcomes analysis in 371 patients shows that IDT doubled their chance of successful treatment with no greater risk of therapeutic failure. Positive IDT, following negative SPT, is clinically relevant and offers superior sensitivity over SPT for detecting allergens clinically relevant to diagnosis of AIT-responsive atopic disease.
format	article
author	David S. Hurst Alan B. McDaniel
author_facet	David S. Hurst Alan B. McDaniel
author_sort	David S. Hurst
title	Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion
title_short	Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion
title_full	Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion
title_fullStr	Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion
title_full_unstemmed	Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion
title_sort	clinical relevance and advantages of intradermal test results in 371 patients with allergic rhinitis, asthma and/or otitis media with effusion
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c88b3aa75eec40a3bcfba00273361e7f
work_keys_str_mv	AT davidshurst clinicalrelevanceandadvantagesofintradermaltestresultsin371patientswithallergicrhinitisasthmaandorotitismediawitheffusion AT alanbmcdaniel clinicalrelevanceandadvantagesofintradermaltestresultsin371patientswithallergicrhinitisasthmaandorotitismediawitheffusion
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Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion

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