Is there a role for immunoblots in the diagnosis of latex allergy? Intermethod comparison of in vitro and in vivo IgE assays in spina bifida patients.
BACKGROUND
The best diagnostic method for latex allergy is still controversial. This investigation was designed to evaluate the diagnostic efficiency of immunoblotting in comparison with established in vitro and in vivo test systems.


METHODS
A total of 108 spina bifida patients were investigated by questionnaire and skin prick test (SPT). Specific serum IgE to latex was analyzed by the Pharmacia CAP FEIA immunoassay, DPC AlaSTAT microplate immunoassay, and DPC AlaBLOT immunoblot. Patients were regarded as latex allergic if they reacted positively to challenge by the latex glove wearing test.


RESULTS
Thirty-four patients reacted positively to challenge. The sensitivity rates were 97% (SPT), 94% (immunoblot, CAP), 74% (AlaSTAT), and 35% (clinical history). The specificity rates were 92% (clinical history), 88% (AlaSTAT), 77% (SPT), 76% (CAP), and 69% (immunoblot). If two methods were combined, efficiency rates were highest for SPT combined with CAP (sensitivity 94%, specificity 82%), with AlaSTAT (sensitivity 74%, specificity 92%), or with immunoblot (sensitivity 91%, specificity 84%). The sera of challenge-positive patients recognized more immunoblot bands than challenge-negative patients, and the severity of symptoms correlated with the number of recognized bands. CONCLUSIONS The diagnostic efficiency of immunoblotting is not superior to that of SPT. However, immunoblotting may serve as an additional tool to increase slightly the specificity of SPT and specific serum IgE tests.
Grüber
C
C
Children's Hospital Charité, Humboldt University, Berlin, Germany.
Buck
D
D
Wahn
U
U
Niggemann
B
B
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015151:Immunoblotting / Q000379:methods*; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D020315:Latex Hypersensitivity / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D012680:Sensitivity and Specificity; D012882:Skin Tests; D016135:Spinal Dysraphism / Q000150:complications / Q000276:immunology*
D000485:Allergens; D007073:Immunoglobulin E