title: Use of modified radioallergosorbent testing in determining initial immunotherapy doses.
abstract: Proponents of the modified radioallergosorbent test (RAST) for allergy diagnosis claim an advantage over skin testing in that immunotherapy may often be safely begun at higher initial concentrations and maintenance achieved with fewer injections than with conventional schedules. The resulting fewer visits would offset the greater initial cost and the delay in obtaining results. The most important allergen for 58 consecutive patients with seasonal allergic rhinitis beginning immunotherapy was determined from the history, skin testing, and aeroallergen surveys. A modified RAST was performed for these allergens. Thirty-nine patients (67%) had a modified RAST class 5 (most severe); 18 patients (31%) were class 4, and one patient was class 3. Since the initial concentration and total number of injections projected to reach maintenance vary little between our conventional schedule (1:100,000 w/v, 23 injections), and those for class 5 (1:62,500 w/v, 27 injections) and class 4 (1:12,500 w/v, 21 injections), the modified RAST offers no advantage over skin testing and conventional immunotherapy dosing in our patient population.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D006801:Humans; D007167:Immunotherapy; D008875:Middle Aged; D011058:Pollen / Q000276:immunology; D011852:Radioallergosorbent Test; D011863:Radioimmunoassay; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy*; D012882:Skin Tests