title: Decreased risk for atopic disorder associated with highly hyperreactive tuberculin skin test reaction in children and adolescents.
abstract: BACKGROUND
  It is speculated that the exposure to Mycobacterium tuberculosis, either by infection or by Bacillus Calmette-Guérin vaccination, may inhibit the onset of atopy by the modification of immune profiles leading to a shift of T(H)1/T(H)2 balance to the T(H)1 side.
  
  
  OBJECTIVE
  One hundred eighty-six patients hyperreactive at tuberculin skin test (TST) were examined in order to investigate the prevalence of atopic disorder, particularly referring to the association between the size of the TST induration and the prevalence of sensitization and manifest atopic disorder.
  
  
  METHODS
  The study consisted of a family history record, patients' medical history assessment and clinical examination, skin prick test (SPT), serum total and allergen-specific IgE (sIgE) measurement and eosinophil count.
  
  
  RESULTS
  Atopic disorder was present in 49 (26.3%) patients tested. No significant difference between the groups based on the TST induration size (15-24 mm vs. > or =25 mm) was found for gender distribution, family atopy history, total IgE measurement, eosinophil count, positive SPT, and the presence of sIgE. A significant difference was found for the age median (14.0 years vs. 13.0 years), childhood atopy record, and manifest atopic disorder. No association between the size of the TST induration and the incidence of allergic sensitization was demonstrated. However, a significant inverse association between the size of the TST induration and manifest atopic disorder was demonstrated.
  
  
  CONCLUSIONS
  In patients highly hyperreactive at TST, the size of the induration is inversely associated with manifest atopic disorder.
authors.affiliation: Srebrnjak Children's Hospital, Srebrnjak 100, Zagreb 10000, Croatia. macesic@bolnica-srebrnjak.hr
authors.forename: Marija
authors.initials: M
authors.lastname: Maćesić
authors.forename: Mirjana
authors.initials: M
authors.lastname: Turkalj
authors.forename: Zaneta
authors.initials: Z
authors.lastname: Jelcić
authors.forename: Slavica
authors.initials: S
authors.lastname: Dodig
authors.forename: Branka
authors.initials: B
authors.lastname: Kristić-Kirin
authors.forename: Boro
authors.initials: B
authors.lastname: Nogalo
authors.forename: Davor
authors.initials: D
authors.lastname: Plavec
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004804:Eosinophils; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D006968:Hypersensitivity, Delayed / Q000097:blood / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D012306:Risk; D012882:Skin Tests; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E