Reproducibility of skin testing and serum venom specific IgE in Hymenoptera venom allergy.
BACKGROUND
The decision regarding an immunotherapy regimen for venom-allergic patients is based on the results of skin testing and serum venom specific IgE measurements. However, their reliability has been questioned, and their reproducibility has not been examined.


OBJECTIVE
To evaluate the reproducibility and reliability of the results of skin testing and serum venom specific IgE measurement in venom-allergic patients.


METHODS
Patients with a systemic reaction after an insect sting were evaluated twice, 2 to 6 weeks apart, by intradermal skin tests and by determination of serum venom specific IgE to Hymenoptera venoms.


RESULTS
Thirty-five patients were evaluated 1 to 168 months (mean, 23 months) after the sting reaction. Reproducibility of skin test results for all venoms at the 2 sessions was found in 23 patients (66%). Reproducibility of venom specific IgE results for all venoms was found in 16 (59%) of 27 patients from whom 2 blood samples were available for evaluation. Concordance between skin test and venom specific IgE results for all venoms was found in 30 (51%) of 59 samples available for evaluation.


CONCLUSIONS
The reproducibility of venom skin test and serum venom specific IgE results is relatively poor. It is common practice for therapeutic decisions regarding venom immunotherapy to be based on a single diagnostic evaluation. Consequently, many patients are either overtreated or undertreated. Better diagnostic methods are required in venom allergy.
Graif
Yael
Y
Allergy and Clinical Immunology Unit, Campus Belinson, Rabin Medical Center, Petah-Tikva, Israel.
Confino-Cohen
Ronit
R
Goldberg
Arnon
A
D000293:Adolescent; D000328:Adult; D000818:Animals; D001180:Arthropod Venoms / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000097:blood / Q000209:etiology / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood*; D007299:Insect Bites and Stings / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D015203:Reproducibility of Results; D012882:Skin Tests / Q000379:methods*
D001180:Arthropod Venoms; D007073:Immunoglobulin E