title: Bites of the European pigeon tick (Argas reflexus): Risk of IgE-mediated sensitizations and anaphylactic reactions.
abstract: BACKGROUND
  Local and systemic reactions can occur after bites of Argas reflexus (Argas), a soft tick parasitizing pigeons.
  
  
  OBJECTIVE
  Risk assessment of IgE-mediated sensitizations and systemic reactions after Argas bites.
  
  
  METHODS
  Case histories, skin prick tests (SPTs) with a whole-body extract of Argas containing major allergen Arg r 1, and common inhalants and specific IgE measurements were obtained from 148 subjects who had had Argas bites and 20 volunteers as a control group.
  
  
  RESULTS
  Systemic reactions (urticaria, angioedema, dyspnea, cardiovascular dysregulation, unconsciousness) were reported in 12 of 148 (8%); 146 of 148 (99%) had local reactions. Atopy was found in 37 of 146 (25%) with local reactions and 3 of 12 (25%) with systemic reactions. SPT to Argas was positive in 24 of 148 (16%) with a high proportion of atopics 10 of 24 (42%); specific IgE to Argas was detectable in 12 of 135 (8% of 148) with moderate concordance to systemic reactions. No positive SPT or specific IgE results to Argas were obtained in the control group. Immunoblotting of 23 sera revealed an IgE-binding protein in 19 of 23 sera (82%) at 22 kd, indicating a major allergen of Argas.
  
  
  CONCLUSIONS
  Severe anaphylactic reactions were infrequently (approximately 8%) found after bites of the soft tick Argas reflexus. Atopy is a risk factor for skin sensitizations to Argas, but not for systemic reactions after bites by Argas. Using a whole-body extract of Argas, diagnosis through SPT and specific IgE is hampered by false-negative and irrelevant positive results, particularly in atopy.
authors.affiliation: Division of Allergy, Occupational Dermatology and Environmental Medicine, Clinics and Outpatient Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany. kleine-tebbe@allergie-experten.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleine-Tebbe
authors.forename: Anja
authors.initials: A
authors.lastname: Heinatz
authors.forename: Inken
authors.initials: I
authors.lastname: Gräser
authors.forename: Hans
authors.initials: H
authors.lastname: Dautel
authors.forename: Gitte Nordskov
authors.initials: GN
authors.lastname: Hansen
authors.forename: Sabine
authors.initials: S
authors.lastname: Kespohl
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Rihs
authors.forename: Monika
authors.initials: M
authors.lastname: Raulf-Heimsoth
authors.forename: Günther
authors.initials: G
authors.lastname: Vater
authors.forename: Manfred
authors.initials: M
authors.lastname: Rytter
authors.forename: Uwe-Fritjof
authors.initials: UF
authors.lastname: Haustein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000209:etiology*; D000818:Animals; D026864:Argas / Q000276:immunology*; D001733:Bites and Stings / Q000276:immunology*; D002648:Child; D010856:Columbidae / Q000469:parasitology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E