The risk of systemic reactions to skin prick-tests using food allergens: CICBAA data and literature review.
Prick-tests to foods are usually carried out as the first step in the diagnosis of food allergy. Severe anaphylaxis accounts for 4.9 % of allergies in children and occurs more frequently in adults, raising the possibility of systemic reactions to prick-tests in highly sensitized people. Several studies published in the literature have used commercial extracts. As for airborne allergens, concentrations causing a skin reaction of 15 mm do not present a risk of systemic reactions. Prick-tests to native foods--prick-in-prick tests--have been less extensively studied. The CICBAA1 data, from 1,138 food allergic patients of all ages, cover 34,905 prick-in-prick tests to foods. The wheal of these prick-tests has been regulary registered. The risk of systemic reactions can be evaluated at 0.008 %. There were no severe reactions and anti-histamine and corticosteroid therapy were sufficient. These results are similar to those of the large study in 2000 carried out by Devenney in neonates (0.005%). A review of the literature reveals only a few severe reactions in adults. The authors draw attention to the necessary precautions: temporary contra-indication for skin prick-tests in children and adults with grade 3 or 4 asthma, with particular attention to such foods as all kinds of nuts, fish, etc.
Codreanu
F
F
Médecine Interne, Immunologie Clinique et Allergologie, Hôpital Central 29, Nancy.
Moneret-Vautrin
D A
DA
Morisset
M
M
Guénard
L
L
Rancé
F
F
Kanny
G
G
Lemerdy
Ph
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects*; D031021:Anacardium / Q000009:adverse effects; D000799:Angioedema / Q000209:etiology*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data; D004531:Eggs / Q000009:adverse effects; D005260:Female; D005399:Fishes; D005512:Food Hypersensitivity / Q000150:complications*; D006636:Histamine Release; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D021183:Peanut Hypersensitivity / Q000150:complications; D012306:Risk; D017747:Seafood / Q000009:adverse effects; D012882:Skin Tests / Q000009:adverse effects*; D014581:Urticaria / Q000209:etiology*
D000485:Allergens