title: Diagnostic value of specific IgE analysis in latex allergy.
abstract: BACKGROUND
  The precision of the methods used to diagnose latex allergy is of great importance due to false-positive results. Neither the skin prick test (SPT) nor the latex-specific IgE assay has 100% diagnostic accuracy. We analysed the diagnostic value of latex-specific IgE by the first-ever concomitant use of the SPT and nasal provocation test (NPT).
  
  
  METHODS
  Twenty-seven latex-sensitive patients (group 1), 46 aeroallergen-sensitive patients (group 2a) and 33 healthy subjects (group 2b) participated in the study. All groups underwent an SPT with latex and aeroallergens and an NPT with latex. Latex-specific IgE and total IgE levels were measured by the ImmunoCAP assay.
  
  
  RESULTS
  Latex-specific IgE was positive in 92.6, 30.4 and 9.1% of groups 1, 2a and 2b, respectively. The 11 aeroallergen-sensitive patients in group 1 and all of the patients in group 2a were predominantly sensitised to pollens (grass, weed and tree) and reacted to a lesser degree to house dust mite, moulds and animal dander. Combined pollinosis was remarkably more prevalent in patients with positive latex-specific IgE in group 2a than in those with negative latex-specific IgE (p = 0.001). The NPT was positive in 84.6% of group 1 and negative in all control subjects. The sensitivity, specificity, negative predictive value and positive predictive value of the latex-specific IgE assay were 90.9, 72.2, 96.3 and 50%, respectively.
  
  
  CONCLUSIONS
  The high rate of false-positive results for latex-specific IgE by ImmunoCAP should be taken into account when making a diagnosis of latex allergy in patients with pollinosis, especially in those sensitised to more than one pollen species.
authors.affiliation: Division of Allergy, Department of Internal Medicine, Tepecik Training and Research Hospital, İzmir, Turkey. unselmehmet@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Unsel
authors.forename: Nihal
authors.initials: N
authors.lastname: Mete
authors.forename: Omür
authors.initials: O
authors.lastname: Ardeniz
authors.forename: Aytül
authors.initials: A
authors.lastname: Sin
authors.forename: Okan
authors.initials: O
authors.lastname: Gülbahar
authors.forename: Ali
authors.initials: A
authors.lastname: Kokuludağ
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D000918:Antibody Specificity; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis / Q000097:blood*; D007840:Latex / Q000276:immunology*; D020315:Latex Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009299:Nasal Provocation Tests; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D007840:Latex; D007073:Immunoglobulin E